Costello, Agnes Katherine

Costello, Agnes Katherine is an individual health care provider with primary practice located at 25 N Winfield Rd , Winfield IL 60190-1295. She recently has only one registered license in Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, which is considered as her primary health care specialty. Costello, Agnes Katherine can be contacted via phone (630) 933-6631.

Contact Information

Primary practice address
25 N Winfield Rd Winfield IL 60190-1295
Phone: (630) 933-6631
Fax: (630) 933-4936
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 036117700 Illinois

Profile Details

NPI number 1770748865
LBN Legal business name Costello, Agnes Katherine
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2008
Last updated Dec 2nd, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770748865 NPPES
Illinois MEDICAID 036117700
Illinois Other 206147
Illinois Other 206147218

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