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General NPI Number Information
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NPI Number | 1750898367
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Entity Type | Individual
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Provider Name | NSO AGBOR NSO MD
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Gender | Male
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Dates
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Enumeration Date | 01/04/2018
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Last Update Date | 08/06/2024
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Provider Practice Location Address
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Address Line | 2650 RIDGE AVE. IM/ICU HOSPITALISTS
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City | BURR EVANSTON
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State | IL
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Zip | 60201-1718
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Country | US
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Telephone | 847-570-1010
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Fax | 847-733-5108
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Provider Business Mailing Address
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Address Line | 2650 RIDGE AVE. IM/ICU HOSPITALISTS
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City | BURR EVANSTON
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State | IL
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Zip | 60201-1718
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Country | US
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Telephone | 847-570-1010
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Fax | 847-733-5108
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 036167294
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 125079225
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License Number State | IL
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Taxonomy #6
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036167294
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License Number State | IL
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Taxonomy #8
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 036167294
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License Number State | IL
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