Individual
REBECCA S WANGARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
751 N RUTLEDGE ST # 100, SPRINGFIELD, IL 62702-4968
(217) 545-8000
Mailing address
201 E MADISON ST STE 328, SPRINGFIELD, IL 62702-5131
(217) 545-8000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209-007164
IL
Other
Enumeration date
08/01/2008
Last updated
12/15/2022
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