Organization
MICHAEL WAGNER, S.C.
Active
Organization
MICHAEL WAGNER, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL THOMAS WAGNER M.D. (PRESIDENT)
(847) 987-5450
Entity
Organization
Contact information
Practice address
650 E DIEHL RD, SUITE 121, NAPERVILLE, IL 60563-4801
(847) 987-5450
Mailing address
650 E DIEHL RD, SUITE 121, NAPERVILLE, IL 60563-4801
(847) 987-5450
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
042619749
IL
Other
Enumeration date
12/24/2012
Last updated
09/26/2022
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