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1124331152
PAULA J WAGNER
CHICAGO, IL
NPI
1124331152
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: IL 209008086)
Enumeration Date
2010-07-19
Last Update Date
2019-01-27
Business Address
PAULA J WAGNER APN
6150 N BROADWAY ST
CHICAGO, IL 60660
Phone number: 866-389-2727
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Mailing Address
PAULA J WAGNER APN
6150 N BROADWAY ST
CHICAGO, IL 60660-2538
Phone number: 866-389-2727
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