Individual
DR. LAUREN E WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
333 E ONTARIO ST, SUITE 3303B, CHICAGO, IL 60611-4804
(312) 255-8111
Mailing address
333 E. ONTARIO ST., SUITE 3303B, CHICAGO, IL 60611
(312) 255-8111
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036-100517
IL
Other
Enumeration date
04/25/2008
Last updated
04/25/2008
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