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1043091861
TANYA WAGNER
CHICAGO, IL
NPI
1043091861
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: IL 209028368)
Enumeration Date
2023-10-09
Last Update Date
2024-05-01
Business Address
TANYA WAGNER FNP-C
200 E 75TH ST STE 200
CHICAGO, IL 60619-2280
Phone number: 872-231-4100
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Mailing Address
TANYA WAGNER FNP-C
200 E 75TH ST STE 200
CHICAGO, IL 60619-2280
Phone number: 872-231-4100
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