Individual
ALEXA WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
13400 S ROUTE 59 STE 116-326, PLAINFIELD, IL 60585-5826
(815) 267-7334
(630) 429-9411
Mailing address
3815 E MAIN ST STE B, ST CHARLES, IL 60174-2488
(630) 584-7530
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146014611
IL
235Z00000X
Speech-Language Pathologist
—
IL
Other
Enumeration date
08/17/2017
Last updated
12/10/2021
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