Alan S Wagner, MD | |
3849 N Perryville Rd, Rockford, IL 61114-8080 | |
(815) 397-5554 | |
(866) 914-7534 |
Full Name | Alan S Wagner |
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Gender | Male |
Speciality | Radiology - Diagnostic Radiology |
Location | 3849 N Perryville Rd, Rockford, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1497701684 | NPI | - | NPPES |
036099687 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2085R0202X | Radiology - Diagnostic Radiology | 36-099687 (Illinois) | Primary |
Entity Name | Mercy Health System Corporation |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1598718603 PECOS PAC ID: 7416860440 Enrollment ID: O20031113000164 |
Entity Name | Beloit Radiology Ltd |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1386661734 PECOS PAC ID: 3274559711 Enrollment ID: O20051024000425 |
Mailing Address | Practice Location Address |
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Alan S Wagner, MD 3849 N Perryville Rd, Rockford, IL 61114-8080 Ph: (815) 397-5554 | Alan S Wagner, MD 3849 N Perryville Rd, Rockford, IL 61114-8080 Ph: (815) 397-5554 |
Christopher Vittore, Radiology Medicare: Accepting Medicare Assignments Practice Location: 5666 E State St, Rockford, IL 61108 Phone: 815-226-2000 | |
Martin Butler, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1401 E State St, Rockford, IL 61104 Phone: 888-696-7820 Fax: 815-636-1771 | |
Steven L Schneider, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 2400 N Rockton Ave, Rockford, IL 61103 Phone: 815-971-6205 Fax: 815-636-1771 | |
Dr. Kevin John Nguyen, MD Radiology Medicare: Medicare Enrolled Practice Location: 3871 N Perryville Rd, Rockford, IL 61114 Phone: 815-397-5554 | |
Gustavo A Espinosa, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 3849 N Perryville Road, Rockford, IL 61114 Phone: 815-397-5554 Fax: 866-914-7594 | |
Virendra Saxena, Radiology Medicare: Not Enrolled in Medicare Practice Location: 1401 E State St, Rockford, IL 61104 Phone: 815-961-2030 | |
Hyungmin Kang, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1401 E State St, Rockford, IL 61104 Phone: 815-489-4760 |