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1871089136
ELLEN WAGNER
CHICAGO, IL
NPI
1871089136
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
208000000X Pediatrics
(Licence: IL 125.071819)
Enumeration Date
2018-07-10
Last Update Date
2018-07-10
Business Address
Dr. ELLEN WAGNER MD
5841 S MARYLAND AVE # MC8016
CHICAGO, IL 60637-1443
Phone number: 773-702-6435
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Mailing Address
Dr. ELLEN WAGNER MD
180 HARVESTER DR STE 110
BURR RIDGE, IL 60527-6686
Phone number: 773-702-1150
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