ALAN S. WAGNER (NPI# 1497701684) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497701684 |
| Entity Type | Individual |
| Full Name | ALAN S. WAGNER |
| Credential | M.D. |
| Practice Address |
3849 N Perryville Rd Rockford IL 61114-8080 |
| Practice Telephone | 8153975554 |
| Practice Fax Number | 8669147534 |
| Mailing Telephone | 8153975554 |
| Mailing Fax Number | 8669147534 |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2011-05-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
36-099687 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036099687 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295719631 | Alan Lewis Wagner | Ophthalmology | 6160 Kempsville Cir Ste 120b, Norfolk, VA 23502-3933 | 2005-11-30 |
| 1811597792 | Alan Wagner | Private Vehicle | 795 S Township Road 113, Tiffin, OH 44883-9791 | 2020-10-29 |
| 1104372416 | Alan Wagner | Pharmacist | 2253 N Richmond Rd, Mchenry, IL 60051-5401 | 2016-08-27 |
| 1649248584 | Alan Wagner | Radiology | 33-57 Harrison St, Johnson City, NY 13790 | 2006-03-08 |
| 1164406674 | Alan Marvin Wagner | Obstetrics & Gynecology | 1024 Main St, Woodward, OK 73801-3120 | 2005-11-30 |
| 1881686244 | Alan Duane Wagner | Nurse Anesthetist, Certified Registered | 405 W Jackson St, Carbondale, IL 62901-1462 | 2005-08-22 |
| Street Address |
3849 N PERRYVILLE RD |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61114-8080 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912953191 | Martin A. Urban | Radiology | 3849 N Perryville Rd, Rockford, IL 61114-8080 | 2006-05-26 |
| 1972640282 | Summit Radiology, LLC | Specialist | 3849 N Perryville Rd, Rockford, IL 61114-8080 | 2007-01-30 |
| 1144276338 | Scott S. White | Radiology | 3849 N Perryville Rd, Rockford, IL 61114-8080 | 2006-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366064560 | Caleb Ifeoluwa Oluwadamisi | Student in an Organized Health Care Education/Training Program | Mercy Health Javon Bea Hospital, 8201 East Riverside Boulevard, Rockford, IL 61114 | 2020-05-11 |
| 1811525959 | Seifeldin Eid | Student in an Organized Health Care Education/Training Program | Mercyhealthjavon Bea Hospital, 8201, East Riversideboulevard, IL 61114 | 2020-04-01 |
| 1073167664 | Swedishamerican Hospital | Internal Medicine | 3505 N Bell School Road, Rockford, IL 61114 | 2019-07-31 |
| 1154980076 | Anurag Gill | Student in an Organized Health Care Education/Training Program | 8201 East Riverside Boulevard, Mercy Health Javon Bea Hospital, Rockford, IL 61114 | 2019-06-13 |
| 1578121943 | Sona Najafi | Student in an Organized Health Care Education/Training Program | Mercyhealth Javon Bea Hospital, 8201 East Riverside Blvd, Rockford, IL 61114 | 2019-05-31 |
| 1760045744 | Julianna Jones | Counselor | 6653 Weaver Rd Ste 115, Rockford, IL 61114 | 2019-04-16 |
| 1952869943 | Angela Marie Hawkins | Nurse Practitioner | 8201 E. Riverside Blvd, Pediatric Neurology, Rockford, IL 61114 | 2019-03-08 |
| 1376029231 | Meghan Beth Teske | Chiropractor | 3779 N. Alpine Rd., Rockfod, IL 61114 | 2018-07-13 |
| 1811401284 | Summit Radiology, LLC | Clinic/Center | 3849 N. Perryville Road, Rockford, IL 61114 | 2017-11-21 |
| 1548704299 | Rockford Orthopedic Associates, Ltd | Durable Medical Equipment & Medical Supplies | 5929 E Riverside Blvd, Rockford, IL 61114 | 2016-12-15 |
| Find all providers in zip 61114 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295999225 | Donald E Banicki | Radiology | 6426 Old Hunters Run, Rockford, IL 61114-7812 | 2008-07-18 |
| 1457568859 | Steven Bach | Radiology | 3849 N. Perryvillle Road, Rockford, IL 61114-8080 | 2007-05-16 |
| 1679695332 | Mediscan Imaging Center of Rockford LLC | Radiology | 6957 Olde Creek Rd Ste 4100, Rockford, IL 61114-7416 | 2007-04-04 |
| 1912953191 | Martin A. Urban | Radiology | 3849 N Perryville Rd, Rockford, IL 61114-8080 | 2006-05-26 |
| 1114904620 | Gustavo A Espinosa | Radiology | 3849 N Perryville Road, Rockford, IL 61114 | 2005-12-27 |
| 1609026467 | Rajesh Kumar Kakarla | Radiology | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2008-09-29 |
| 1144476367 | Migena Betz | Radiology | 7180 Spring Brook Rd, Rockford, IL 61114-6700 | 2008-08-08 |
| 1477718377 | Charles Arthur Ambelang | Radiology | 5666 E State St, Rockford, IL 61108-2425 | 2008-07-21 |
| 1144276338 | Scott S. White | Radiology | 3849 N Perryville Rd, Rockford, IL 61114-8080 | 2006-05-26 |
| 1841244753 | Camelot Radiology Associates Ltd | Radiology | 3849 N Perryville Road, Rockford, IL 61114 | 2006-05-22 |
| Find all providers in ROCKFORD | ||||
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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.