Individual provider · Type 1 NPI
Annette M. Wagner, MD
Pediatric Dermatology Physician · Westchester, IL
NPI number
1477515807
Active
Practice location
2301 Enterprise Drive, #81
Westchester, IL 60154
Fax (708) 836-4805
Mailing address
2300 Children's Plaza, #107
Chicago, IL 60614
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Dermatology Physician Primary | 207NP0225X | 036089005 (IL) |
Pediatric Dermatology Physician: A pediatric dermatologist has, through additional special training, developed expertise in the treatment of specific skin disease categories with emphasis on those diseases which predominate in infants, children and adolescents.
About NPI 1477515807
Annette M. Wagner, MD's National Provider Identifier is 1477515807, issued on Apr 3, 2006. The primary taxonomy on file is Pediatric Dermatology Physician (207NP0225X), and the practice location is in Westchester, IL. The record was last updated on Sep 21, 2011.