Wagner, Jean Evelyn Vogel

Wagner, Jean Evelyn Vogel is an individual health care provider with primary practice located at 1230 George E Chance Parkway , Caseyville IL 62232. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Wagner, Jean Evelyn Vogel can be contacted via phone (618) 345-5437.

Contact Information

Primary practice address
1230 George E Chance Parkway Caseyville IL 62232
Phone: (618) 345-5437
Fax: (618) 344-9246
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036105844 Illinois

Profile Details

NPI number 1902909153
LBN Legal business name Wagner, Jean Evelyn Vogel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 6th, 2006
Last updated Dec 5th, 2012 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902909153 NPPES
Illinois MEDICAID 036105844

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