Individual
LINDSAY WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4646 N MARINE DR, CHICAGO, IL 60640
(773) 878-8700
(708) 783-0920
Mailing address
11781 LEE JACKSON MEMORIAL HWY, SUITE 550, FAIRFAX, VA 22033
(571) 777-5106
(703) 563-6256
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
041394642
IL
Other
Enumeration date
04/26/2016
Last updated
05/14/2021
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