Annette M Wagner, MD is a
Dermatology - Pediatric Dermatology physician based in Westchester, Illinois. Annette M Wagner is licensed to practice in Illinois (license number 036089005) and her current practice location is 2301 Enterprise Drive, #81, Westchester, Illinois. She can be reached at her office (for appointments etc.) via phone at
(708) 836-4800.
NPI number for Annette M Wagner is 1477515807 and her current mailing address is 2300 Children's Plaza, #107, Chicago, Illinois. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1477515807.
Physician's Profile
| Full Name | Annette M Wagner |
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| Gender | Female |
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| Speciality | Dermatology - Pediatric Dermatology |
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| Location | 2301 Enterprise Drive, Westchester, Illinois |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1477515807
- Provider Enumeration Date: 04/03/2006
- Last Update Date: 09/21/2011
Medical Identifiers
Medical identifiers for Annette M Wagner such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1477515807 | NPI | - | NPPES |
| 036089005 | Medicaid | IL | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207NP0225X | Dermatology - Pediatric Dermatology | 036089005 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Annette M Wagner is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Annette M Wagner, MD
2300 Children's Plaza, #107,
Chicago, IL 60614
Ph: (312) 227-6060 | Annette M Wagner, MD
2301 Enterprise Drive, #81,
Westchester, IL 60154
Ph: (708) 836-4800 |
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