Organization
LAUREN E. WAGNER, M.D., S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN E WAGNER M.D. (PRESIDENT)
(312) 255-8111
Entity
Organization
Contact information
Practice address
333 E ONTARIO ST, SUITE #3303B, CHICAGO, IL 60611-4804
(312) 255-8111
Mailing address
333 E ONTARIO ST, SUITE #3303B, CHICAGO, IL 60611-4804
(312) 255-8111
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
IL
Other
Enumeration date
02/14/2007
Last updated
08/22/2020
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