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Organization
DRS WAGNER-DEBRE ASSOCIATES SC
Active
Organization
DRS WAGNER-DEBRE ASSOCIATES SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL W DEBRE M.D. (SOLE OWNER (PRESIDENT))
(708) 423-3800
Entity
Organization
Contact information
Practice address
9830 RIDGELAND AVE, SUITE 101, CHICAGO RIDGE, IL 60415-2667
(708) 423-3800
Mailing address
9830 RIDGELAND AVE, SUITE 101, CHICAGO RIDGE, IL 60415-2667
(708) 423-3800
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036053268
IL
Other
Enumeration date
12/17/2007
Last updated
12/29/2009
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