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Individual

BRIDGET NORA WAGNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
(708) 684-8000
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.010348
IL

Other

Enumeration date
03/26/2024
Last updated
08/23/2024
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