Search › Illinois › 363LA2200X
Jeric Agnes, FNP-BC
NPI 1114532611 · on the registry since 2020
Practice
- Address
- 3880 Salem Lake Dr Ste F
Long Grove, IL 60047 - Phone
- (847) 719-2220
- Fax
- (847) 719-2265
- Organisation at this address
- Fairbanks, Llc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 82
Registry record
- Primary taxonomy
- 363LA2200X
363LA2200X
- Also registered as
- 163W00000X
363LF0000X - Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2023-10-25
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois