ELLEN AFRICANO WAGNER

FLOSSMOOR, IL
NPI1679975411
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: IL  209.012203)
Additional Taxonomies163W00000X Registered Nurse
(Licence: IL  041372498)
Enumeration Date2014-09-24
Last Update Date2022-07-21
Business Address
-- ELLEN AFRICANO WAGNER CRNA
19624 GOVERNORS HWY
FLOSSMOOR, IL 60422-2077
Phone number: 708-798-5838
Mailing Address
-- ELLEN AFRICANO WAGNER CRNA
1713 N VINE ST
CHICAGO, IL 60614-5119
Phone number: 312-513-2177