E. Wagner'S Shoes

LBN: E. Wagner'S Shoes
E. Wagner'S Shoes is an health care organization with primary practice located at 7379 North Ave , River Forest IL 60305-1230. The organization recently has only one registered license in Suppliers / Prosthetic/Orthotic Supplier, which is considered as the primary health care specialty. E. Wagner'S Shoes can be contacted via phone (708) 771-4528, or through Stout, Jerry L. via phone (708) 771-4528.

Contact Information

Primary practice address
7379 North Ave River Forest IL 60305-1230
Phone: (708) 771-4528
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Stout, Jerry L.
Phone: (708) 771-4528

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Prosthetic/Orthotic Supplier 335E00000X 0887330001 Illinois

Profile Details

NPI number 1104983337
LBN Legal business name E. Wagner'S Shoes
DBA Doing business as
Authorized official Stout, Jerry L.
Entity Organization
Organization subpart 1 No
Enumeration date Jan 3rd, 2007
Last updated Dec 17th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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