DR. AMY CLAIRE WAGNER (NPI# 1568516698) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568516698 |
| Entity Type | Individual |
| Full Name | DR. AMY CLAIRE WAGNER |
| Credential | PH.D., L.M.F.T. |
| Practice Address |
104 Central Park Ave Wilmette IL 60091-3202 |
| Practice Telephone | 8477210965 |
| Mailing Telephone | 8477210965 |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2020-08-07 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
071003893 | IL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639642937 | Amy Danielle Wagner | Marriage & Family Therapist | 523 Dixie St Ste 5, Carrollton, GA 30117-3870 | 2019-01-09 |
| 1649695628 | Amy L. Wagner | Behavioral Analyst | 1128 Beville Road, Suite A, Daytona Beach, FL 32114 | 2014-02-27 |
| 1538463997 | Amy Lyn Wagner | Occupational Therapist | 2820 E 53rd Ave, Apt # 48, Spokane, WA 99223-7962 | 2010-12-28 |
| 1710033097 | Amy E Wagner | Physical Therapist | 1428 S Marengo Ave, Alhambra, CA 91803-3001 | 2007-01-26 |
| 1174186217 | Amy Marie Wagner | Student in an Organized Health Care Education/Training Program | 6901 Bertner Ave, Houston, TX 77030-3901 | 2019-04-15 |
| 1639654437 | Amy Elizabeth Wagner | Speech-Language Pathologist | 631 Main Street, Richfield, PA 17086 | 2018-09-27 |
| 1568989697 | Amy S Wagner | Counselor | 3544 Edgewater Dr, Orlando, FL 32804-2922 | 2017-08-29 |
| 1942742804 | Amy Nicole Wagner | Nurse Practitioner | 150 N Robertson Blvd, Beverly Hills, CA 90211-2142 | 2016-11-09 |
| 1801340393 | Amy Wagner | Counselor | 2272 95th St, Unit 305, Naperville, IL 60564-8942 | 2016-08-12 |
| 1376997890 | Amy Wagner | Registered Nurse | 940 E 8th St, Traverse City, MI 49686-2893 | 2016-04-21 |
| Street Address |
104 CENTRAL PARK AVE |
| City | WILMETTE |
| State | IL |
| Zip Code | 60091-3202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689284408 | Tanner Hoegh | Counselor | Address: 825 Green Bay Rd, Suite 200, Wilmette, IL 60091 | 2020-08-06 |
| 1205301082 | Charles Michael Falcone | Anesthesiology | 2743 Illinois Road, Wilmette, IL 60091 | 2018-10-09 |
| 1134646219 | Shari Beth Nivasch | Counselor | 445 Beverly Drive, Wilmette, IL 60091 | 2017-08-29 |
| 1508288440 | Debra Anne Brodd | Chiropractor | 522 Poplar, Wilmette, IL 60091 | 2014-01-13 |
| 1720411085 | Catherine Elizabeth Zwergel | Acupuncturist | 1215 Washington Ave Ste 203, Wilmette, IL 60091 | 2013-08-09 |
| 1447693106 | Michael Joseph Engelman | Dentist | 1625 Sheridan Rd. Suite M, Wilmette, IL 60091 | 2013-04-12 |
| 1720365117 | Anna Kielar | Pharmacist | 811 Greenbay Rd, Wilmette, IL 60091 | 2011-11-14 |
| 1306128368 | Victoriya Kharon | Pharmacist | 811 Greenbay Road, Wilmette, IL 60091 | 2011-09-15 |
| 1154626653 | Mary Jo Schmitz | Physical Therapist | 3330 Old Glenview Rd., Suite 4, Wilmette, IL 60091 | 2011-01-14 |
| 1053622522 | Stephanie Lynn Kutzen | Social Worker | 1925 Lake Avenue, Suite 305, Wilmette, IL 60091 | 2010-06-29 |
| Find all providers in zip 60091 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982190633 | Illuminate Psychological Assessments, LLC | Psychologist | 3330 Old Glenview Rd Ste 10, Wilmette, IL 60091-2963 | 2018-07-05 |
| 1316465412 | Linebarger & Associates, Ltd. | Psychologist | 1159 Wilmette Ave Ste 225, Wilmette, IL 60091-2653 | 2017-09-08 |
| 1235660317 | Pamela Rezek LLC | Psychologist | 819 Greenwood Ave, Wilmette, IL 60091-1749 | 2017-03-21 |
| 1205283793 | Diane Gruner Goodwin | Psychologist | 3330 Old Glenview Rd Ste 5, Wilmette, IL 60091-2963 | 2016-05-16 |
| 1104218627 | John Knapp | Psychologist | 400 Linden Ave Ste 2, Wilmette, IL 60091-2883 | 2015-02-19 |
| 1720485436 | Patricia Ann Lavallee | Psychologist | 1017 Central Ave, Wilmette, IL 60091-2609 | 2014-11-24 |
| 1649617069 | Susan London | Psychologist | 3223 Lake Ave, Suite # 15c-396, Wilmette, IL 60091-1069 | 2013-05-24 |
| 1841529187 | Anna Marie Buchmann | Psychologist | 2407 Iroquois Rd, Wilmette, IL 60091-1366 | 2009-12-16 |
| 1659581247 | Martin Howard Blackman | Psychologist | 207 3rd St, Wilmette, IL 60091-3440 | 2007-05-23 |
| 1316164619 | Paul D London | Psychologist | 1213 Forest Ave, Wilmette, IL 60091-1656 | 2007-04-19 |
| Find all providers in WILMETTE | ||||
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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.