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
Phone: (847) 740-4300
Fax:
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1922193028 | NPPES |
| Illinois | MEDICAID | 036082201 |
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