Individual
DR. MELISSA LYNNE WAGNER-SCHUMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
912 S WOOD ST, CHICAGO, IL 60612-4300
(312) 996-0123
Mailing address
912 S WOOD ST, CHICAGO, IL 60612-4300
(312) 996-0123
(312) 413-1228
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
036.144446
IL
2084P0800X
Psychiatry Physician
Primary
036.144446
IL
2084P0800X
Psychiatry Physician
35.129457
OH
2084P0804X
Child & Adolescent Psychiatry Physician
036.144446
IL
2084P0804X
Child & Adolescent Psychiatry Physician
35.129457
OH
Other
Enumeration date
05/31/2012
Last updated
02/05/2018
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