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General NPI Number Information
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NPI Number | 1467312942
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Entity Type | Organization
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Legal Business Name | AGILITY HEALTHCARE GROUP
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Dates
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Enumeration Date | 11/17/2025
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Last Update Date | 11/17/2025
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Provider Practice Location Address
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Address Line | 6524 N ROCKWELL ST
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City | CHICAGO
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State | IL
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Zip | 60645-5322
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Country | US
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Telephone | 312-312-7907
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Fax | 312-312-7989
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Provider Business Mailing Address
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Address Line | 6524 N ROCKWELL ST
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City | CHICAGO
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State | IL
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Zip | 60645-5322
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Country | US
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Telephone | 312-312-7907
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Fax | 312-312-7989
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Authorized Official
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Title or Position | OWNER
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Name | MILNESHA L PEREZ
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Credential |
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Telephone | 312-312-7907
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 292200000X
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Taxonomy Name | Dental Laboratory
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License Number |
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License Number State |
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