Individual
ANNE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
800 HIGHVIEW DR, ANTIOCH, IL 60002-1141
(847) 838-8369
Mailing address
935 DEER PATH DR, ANTIOCH, IL 60002-2499
(224) 456-0128
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2625595
IL
Other
Enumeration date
09/26/2023
Last updated
09/26/2023
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