Individual
DR. JEAN EVELYN VOGEL WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1230 GEORGE E CHANCE PARKWAY, CASEYVILLE, IL 62232
(618) 345-5437
(618) 344-9246
Mailing address
1230 GEORGE E CHANCE PARKWAY, CASEYVILLE, IL 62232
(618) 345-5437
(618) 344-9246
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036105844
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036105844
—
IL
Enumeration date
09/06/2006
Last updated
12/05/2012
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