PAULA J WAGNER (NPI# 1124331152) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124331152 |
| Entity Type | Individual |
| Full Name | PAULA J WAGNER |
| Credential | APN |
| Practice Address |
6150 N Broadway St Chicago IL 60660 |
| Mailing Address |
6150 N Broadway St Chicago IL 60660-2538 |
| Practice Telephone | 8663892727 |
| Mailing Telephone | 8663892727 |
| Enumeration Date | 2010-07-19 |
| Last Update Date | 2019-01-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209008086 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 11200 Lincoln Hwy, Mokena, IL 604488208 | 3123431398 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760467948 | Paula Wagner | Nurse Practitioner | 4860 Y St, Suite 2200, Sacramento, CA 95817-2307 | 2005-12-12 |
| Street Address |
6150 N BROADWAY ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60660 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689618043 | Highland Park Cvs LLC | Pharmacy | 6150 N Broadway St, Chicago, IL 60660-2538 | 2006-06-16 |
| 1699386607 | Catherine Veronica Espinosa | Nurse Practitioner | 6150 N Broadway St, Chicago, IL 60660-2538 | 2020-08-12 |
| 1295367407 | Egle Ramaskeviciute | Nurse Practitioner | 6150 N Broadway St, Chicago, IL 60660-2538 | 2020-02-05 |
| 1134767759 | Judith Mongoum Pene | Nurse Practitioner | 6150 N Broadway St, Chicago, IL 60660-2538 | 2019-12-13 |
| 1043798036 | Ellen Tyesha Arnold | Registered Nurse | 6150 N Broadway St, Chicago, IL 60660-2538 | 2018-08-01 |
| 1437588472 | Jennifer Offen | Nurse Practitioner | 6150 N Broadway St, Chicago, IL 60660-2538 | 2013-11-08 |
| 1609120591 | Lyndsey M Powell | Nurse Practitioner | 6150 N Broadway St, Chicago, IL 60660-2538 | 2012-10-31 |
| 1992024368 | Fozia Mohammed | Nurse Practitioner | 6150 N Broadway St, Chicago, IL 60660-2538 | 2010-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225672280 | Alexis Shelton | Behavior Technician | 6317 N Broadway, Chicago, IL 60660 | 2019-11-03 |
| 1912470105 | Pipeline - Lakefront Medical Associates, LLC | Family Medicine | 6201 North Broadway, Chicago, IL 60660 | 2019-01-10 |
| 1417492224 | Aynur Fataliyeva | Non-emergency Medical Transport (VAN) | 5701 N Sheridan Road, Apt 20g, Chicago, IL 60660 | 2017-01-03 |
| 1285187591 | Bryan Moles | Developmental Therapist | 6157 N Kenmore, Apt #4s, Chicago, IL 60660 | 2016-08-03 |
| 1144609181 | Ebm Consulting LLC | Anesthesiology | 5600 N Sheridan Road, #115, Chicago, IL 60660 | 2015-05-22 |
| 1295134112 | Brent E Agran, Dds, LLC | Dentist | 5820 N. Clark St., 1s, Chicago, IL 60660 | 2014-08-15 |
| 1538573258 | Emily Eaton | Student in an Organized Health Care Education/Training Program | 5643 N. Magnolia Ave, Chicago, IL 60660 | 2014-06-20 |
| 1538572664 | Rozina Altaf Virani | Nurse Practitioner | 6033 N Sheridan Rd Ste N6, Chicago, IL 60660 | 2014-06-05 |
| 1548673866 | Emily Mckernan | Social Worker | 5710 N Broadway Ave, Chicago, IL 60660 | 2014-06-04 |
| 1679902324 | Christopher Burgess | Psychologist | 1554 W Hollywood, #storefront, Chicago, IL 60660 | 2013-11-04 |
| Find all providers in zip 60660 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932700911 | Laura Ivette Portillo | Nurse Practitioner | 2727 N Marmora Ave, Chicago, IL 60639-1219 | 2020-11-05 |
| 1265033385 | Carolle M Derradji | Nurse Practitioner | 3256 W Potomac Ave, Chicago, IL 60651-2411 | 2020-11-04 |
| 1104427293 | Katie Michelle O'halloran | Nurse Practitioner | 5841 S Maryland Ave # E500, Chicago, IL 60637-1443 | 2020-11-04 |
| 1578163515 | Deanna Bassette | Nurse Practitioner | 243 E 31st St Apt 401, Chicago, IL 60616-5212 | 2020-10-29 |
| 1891395745 | Vrunda Shah Patel | Nurse Practitioner | 933 W Van Buren St Apt 502, Chicago, IL 60607-3583 | 2020-10-29 |
| 1881291706 | Rita Elue | Nurse Practitioner | 6241 N Winthrop Ave Apt 307, Chicago, IL 60660-2071 | 2020-10-04 |
| 1558976514 | Janice Nicole Kinney | Nurse Practitioner | 10127 S Harding Ave, Chicago, IL 60655-3748 | 2020-09-15 |
| 1881209278 | Monique Graves | Nurse Practitioner | 4912 W Adams St Apt 2, Chicago, IL 60644-4445 | 2020-09-11 |
| 1194339721 | Maureen Iyesogie Diji | Nurse Practitioner | 4658 S Ellis Ave, Chicago, IL 60653-3625 | 2020-09-01 |
| 1669085395 | Emily Calderon | Nurse Practitioner | 5556 N Sheridan Rd Apt 506, Chicago, IL 60640-1677 | 2020-08-24 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.