Individual
CHRISTIAN E WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1818 E WINDSOR RD, URBANA, IL 61802-9566
(217) 255-9670
(217) 255-9650
Mailing address
611 W. PARK ST., BWPC, URBANA, IL 61801-2500
(217) 383-6792
(217) 383-4752
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036092326
IL
Other
Enumeration date
09/01/2006
Last updated
05/16/2014
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