Healthcare Provider Details

I. General information

NPI: 1316175987
Provider Name (Legal Business Name): AGNIESZKA NOWAK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2009
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 S. WASHINGTON ST. EMERGENCY MEDICINE
NAPERVILE IL
60540-7430
US

IV. Provider business mailing address

2650 RIDGE AVE. 1223
SKOKIE IL
60201-1718
US

V. Phone/Fax

Practice location:
  • Phone: 630-527-3000
  • Fax:
Mailing address:
  • Phone: 847-570-2040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number036129826
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: