Individual
DR. LYNNE I. WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
676 N SAINT CLAIR ST, SUITE 200, CHICAGO, IL 60611-2927
(312) 695-6946
(312) 695-4307
Mailing address
1960 N LINCOLN PARK W, UNIT 1310, CHICAGO, IL 60614-5487
(312) 695-6946
(312) 695-4307
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
IL
Other
Enumeration date
10/12/2006
Last updated
07/08/2007
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