Elise Marie Wagner, is a
Occupational Therapist based in Bristol, Illinois. Elise Marie Wagner is licensed to practice in Illinois (license number 056009322) and her current practice location is
23 Hunt St, Bristol, Illinois. She can be reached at her office (for appointments etc.) via phone at
(630) 553-4383.
NPI number for Elise Marie Wagner is 1144710997 and her current mailing address is 321 Spring St, Batavia, Illinois. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1144710997.
Healthcare Provider's Profile
Full Name | Elise Marie Wagner |
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Gender | Female |
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Speciality | Occupational Therapist |
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Location | 23 Hunt St, Bristol, Illinois |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1144710997
- Provider Enumeration Date: 05/17/2018
- Last Update Date: 05/17/2018
Medical Identifiers
Medical identifiers for Elise Marie Wagner such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1144710997 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
225X00000X | Occupational Therapist | 056009322 (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. Elise Marie 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 |
Elise Marie Wagner, 321 Spring St, Batavia, IL 60510-2321 Ph: (815) 931-8524 | Elise Marie Wagner, 23 Hunt St, Bristol, IL 60512-2003 Ph: (630) 553-4383 |
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