Drs Wagner-debre Associates Sc | |
9830 Ridgeland Ave Suite 101 Chicago Ridge IL 60415-2667 | |
(708) 423-3800 | |
Not Available |
Full Name | Drs Wagner-debre Associates Sc |
---|---|
Speciality | Internal Medicine |
Location | 9830 Ridgeland Ave, Chicago Ridge, Illinois |
Authorized Official Name and Position | Michael W Debre (SOLE OWNER (PRESIDENT)) |
Authorized Official Contact | 7084233800 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Drs Wagner-debre Associates Sc 9830 Ridgeland Ave Suite 101 Chicago Ridge IL 60415-2667 Ph: (708) 423-3800 | Drs Wagner-debre Associates Sc 9830 Ridgeland Ave Suite 101 Chicago Ridge IL 60415-2667 Ph: (708) 423-3800 |
NPI Number | 1841474574 |
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Provider Enumeration Date | 12/17/2007 |
Last Update Date | 12/29/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1841474574 | NPI | - | NPPES |
36053268 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 036053268 (Illinois) | Primary |
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