Wagner, Ermil

Wagner, Ermil is an sole proprietor health care provider with primary practice located at 2 E Rollins Rd Suite 103, Round Lake Beach IL 60073-3808. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wagner, Ermil can be contacted via phone (847) 740-4300.

Contact Information

Primary practice address
2 E Rollins Rd Suite 103 Round Lake Beach IL 60073-3808
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036082201 Illinois

Profile Details

NPI number 1922193028
LBN Legal business name Wagner, Ermil
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 4th, 2006
Last updated Jan 25th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1922193028 NPPES
Illinois MEDICAID 036082201

Popular Providers