DARREL WAGGONER


Address: 5841 S Maryland Ave, Mc 0077 Room O-500, Chicago, IL 60637-1447
Phone: 7738349110

DARREL WAGGONER (NPI# 1669595872) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1669595872
Entity Type Individual
Full Name DARREL WAGGONER
Credential M.D.
Practice Address 5841 S Maryland Ave
Mc 0077 Room O-500
Chicago
IL 60637-1447
Mailing Address 180 Harvester Dr
Suite 110
Burr Ridge
IL 60527-5993
Practice Telephone 7738349110
Practice Fax Number 7738340556
Mailing Telephone 7738341061
Mailing Fax Number 7738340946
Enumeration Date 2007-04-10
Last Update Date 2014-04-23
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207SG0201X Medical Genetics
Specialization: Clinical Genetics (M.D.)
036090276 IL Allopathic & Osteopathic Physicians

Office Location

Street Address 5841 S MARYLAND AVE
MC 0077 ROOM O-500
City CHICAGO
State IL
Zip Code 60637-1447

Providers in the same location

NPI Name Taxonomy Address Enumeration
1700887296 Rita Lynn Mcgill Internal Medicine 5841 S Maryland Ave, Chicago, IL 60637-1447 2005-08-09
1447851472 Basirat Sulaiman Nurse Practitioner 5841 S Maryland Ave, Chicago, IL 60637-1443 2020-11-05
1982204061 Martha Daniela Gorski Nurse Practitioner 5841 S Maryland Ave, Chicago, IL 60637-1443 2020-10-28
1841807179 Jason Bugno Pharmacist 5841 S Maryland Ave, Chicago, IL 60637-1443 2020-09-30
1942816798 Emily Mancewicz Registered Nurse 5841 S Maryland Ave, Chicago, IL 60637-1443 2020-09-17
1841805546 Anayeli Locascio Nurse Practitioner 5841 S Maryland Ave, Chicago, IL 60637-1443 2020-09-10
1336752856 Rachel Barsella Registered Nurse 5841 S Maryland Ave, Chicago, IL 60637-1443 2020-08-25
1982215620 Jennifer Risner Registered Nurse 5841 S Maryland Ave, Chicago, IL 60637-1443 2020-08-16
1134739857 Moshe Bedziner Physician Assistant 5841 S Maryland Ave, Chicago, IL 60637-1443 2020-08-06
1427676899 Brittney Blackwell Registered Nurse 5841 S Maryland Ave, Chicago, IL 60637-1443 2020-07-11
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1386263234 Pooja Ramnani Pharmacist 5841 S Maryland Ace, Chicago, IL 60637 2020-04-10
1780220079 Tara Coleman Non-emergency Medical Transport (VAN) 808 E. 63rd Street, Suite 135, Chicago, IL 60637 2019-11-21
1366003501 Valerie Silas Case Management 6330 S King Drive, Chicago, IL 60637 2019-06-27
1205391620 Derek Joseph Fiedler Anesthesiology University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637 2019-02-11
1821573072 Ugochinyere Ohaja Registered Nurse 5656 South Maryland Avenue, Chicago, IL 60637 2018-10-03
1053899138 Won Hee Oh Physician Assistant 5841 S. Maryland Ave., Mc5040, Chicago, IL 60637 2018-08-01
1558854695 Rasidat Adeduntan Internal Medicine 5841 S. Maryland Avenue, [7082], Chicago, IL 60637 2018-06-13
1194235283 Melissa Ann Arangoa Registered Nurse 5841 S. Maryland Ave, Mc 1083, Chicago, IL 60637 2017-10-03
1558880633 Marni Harris Optometrist 5841 S Maryland Ave # S421, Chicago, IL 60637 2017-09-11
1992235105 Vidya Mahavadi Pediatrics 5841 S. Maryland Avenue, Mail Code 8016, Chicago, IL 60637 2017-06-20
Find all providers in zip 60637

Taxonomy Information

Taxonomy Code 207SG0201X
Grouping Allopathic & Osteopathic Physicians
Classification Medical Genetics
Specialization Clinical Genetics (M.D.)

Taxonomy Definition

A clinical geneticist demonstrates competence in providing comprehensive diagnostic, management and counseling services for genetic disorders.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Medical Genetics, 2007. http://www.abmg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Medical Genetics.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1164447413 Lee Shulman Medical Genetics 675 N St Clair Street, Galter Suite 14-200, Chicago, IL 60611-5966 2006-07-13
1962466375 Joel Martin Charrow Medical Genetics Ann& Robert H. Lurie Children's Hospital of Chicago #59, 225 E Chicago Ave, Chicago, IL 60611-2991 2006-04-13
1629051289 Rhonda Spiro Medical Genetics 1801 W Taylor St Ste 2e, Chicago, IL 60612-4795 2005-11-28
1134534597 Joshua Baker Medical Genetics 225 E Chicago Ave, Chicago, IL 60611-2991 2014-06-24
1972883254 Gifty Bhat Medical Genetics 1801 W Taylor St Ste 2e, Ui Health Occ, Chicago, IL 60612-4795 2011-08-18
1538282736 William Brian Dobyns Medical Genetics 5841 S Maryland Ave, Mc 0077, Chicago, IL 60637-1447 2007-04-10
1699870477 Edith Jacobson Chernoff Medical Genetics East 65th St At Lake Michigan, La Rabida Children's Hospital, Chicago, IL 60649 2006-09-14
1790795979 Jeffrey S Dungan Medical Genetics 675 N St Clair Street, Galter Suite 14-200, Chicago, IL 60611-5966 2006-08-09
1083639736 Susan Concepcion Echiverri Medical Genetics 1901 W Harrison St, Stroger Hospital of Cook County Ax1159, Chicago, IL 60612-3714 2006-07-13
1699743088 Barbara Kay Burton Medical Genetics 2300 Childrens Plaza, Chicago, IL 60614 2006-03-10
Find all providers in CHICAGO

Competitor

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City CHICAGO
Zip Code 60637

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Dataset Information

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.

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