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DR. CHARLES W LAGOSKI DO NPI 1164479424


NPI Information

NPI: 1164479424
Provider Name: DR. CHARLES W LAGOSKI, DO
Classification: Family Medicine - 207QG0300X
Entity Type: Individual

Specialization: Geriatric Medicine

PECOS Registration: Yes

Address:
530 NE GLEN OAK AVE
PEORIA, IL
ZIP 61636
Phone: (309) 624-8818
Get Directions

DR. Charles W Lagoski, DO is a geriatric medicine family medicine in Peoria, IL with 45 years of experience. The provider is a family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. DR. Charles W Lagoski, DO NPI is 1164479424. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: MIDWESTERN UNIVERSITY, CHICAGO COLLEGE OF OSTEOPATHIC MED
Graduation Year:1979

The provider's business location address is:

530 NE GLEN OAK AVE
PEORIA, IL
ZIP 61636-001
Phone: (309) 624-8818
Fax: (309) 624-8820

The NPI 1164479424 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/30/2006 and was last updated on 10/17/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine036060508ILLINOISNo
2207QG0300XFamily MedicineGeriatric Medicine036060508ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1K34426MEDICARE PINILLINOIS
2B54404MEDICARE UPINILLINOIS
3036060508MEDICAIDILLINOIS
4392880MEDICARE OSCAR/CERTIFICATIONILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.