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Individual

HILARY WAGNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA, MSN

Contact information

Practice address
251 E. HURON, FEINBERG 5‑704, CHICAGO, IL 60611-2908
(312) 695-4146
Mailing address
3190 CAMDEN DR, TROY, MI 48084-7022
(248) 252-4704

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041416829
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209011234
IL

Other

Enumeration date
02/10/2014
Last updated
03/11/2024
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