| Michael Wagner, S.c. | |
|
650 E Diehl Rd Suite 121 Naperville IL 60563-4801 | |
| (847) 987-5450 | |
| Not Available |
| Full Name | Michael Wagner, S.c. |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 650 E Diehl Rd, Naperville, Illinois |
| Authorized Official Name and Position | Michael Thomas Wagner (PRESIDENT) |
| Authorized Official Contact | 8479875450 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Wagner, S.c. 650 E Diehl Rd Suite 121 Naperville IL 60563-4801 Ph: (847) 987-5450 | Michael Wagner, S.c. 650 E Diehl Rd Suite 121 Naperville IL 60563-4801 Ph: (847) 987-5450 |
| NPI Number | 1700122595 |
|---|---|
| Provider Enumeration Date | 12/24/2012 |
| Last Update Date | 09/26/2022 |
| Certification Date | 09/26/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700122595 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 042619749 (Illinois) | Primary |
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