Jerome P Wagner (NPI# 1487664850, PAC ID# 5698951424) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PSYCHOLOGIST, CLINICAL.
| Nation Provider ID (NPI) | 1487664850 |
| PAC ID by PECOS | 5698951424 |
| Professional Enrollment ID | I20110512000398 |
| Full Name | Jerome P Wagner |
| Address |
2603 Broadway Evanston IL 60201-1501 |
| Phone Number | 8474006507 |
| Gender | M |
| Medical School | LOYOLA UNIVERSITY OF CHICAGO, STRITCH SCHOOL OF MEDICINE |
| Graduation Year | 1981 |
| Primary Specialty | PSYCHOLOGIST, CLINICAL |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 2603 Broadway, Evanston, IL 60201-1501 | 8474006507 |
| Street Address |
2603 BROADWAY |
| City | EVANSTON |
| State | IL |
| Zip | 60201-1501 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Therese J Given | Clinical Social Worker | 3008 Central St, Evanston, IL 60201-1101 | |
| Kristina Byzyka | Optometry | Rosin Optical Co Inc | 2914 Central St, Evanston, IL 60201-1237 |
| George Pawlyk | Optometry | Rosin Optical Co Inc | 2914 Central St, Evanston, IL 60201-1237 |
| Kevin Pfeiffer | Optometry | Rosin Optical Co Inc | 2914 Central St, Evanston, IL 60201-1237 |
| Robert Lee Behrends | Podiatry | 1713 Central St, Evanston, IL 60201-1507 | |
| Todd S Newberger | Internal Medicine | 1713 Central St, Evanston, IL 60201-1507 | |
| Alan A Harvey | Maxillofacial Surgery | 2650 Ridge Ave, Evanston, IL 60201-1700 | |
| Adela Kola | Hospitalist | Northshore University Healthsystem Faculty Practice Associates | 2650 Ridge Ave, Evanston, IL 60201-1718 |
| Lynn K Martin | Internal Medicine | Northshore University Healthsystem Faculty Practice Associates | 2650 Ridge Ave, Evanston, IL 60201-1718 |
| Jason H Kang | Pathology | Northshore University Healthsystem Faculty Practice Associates | 2650 Ridge Ave, Evanston, IL 60201-1718 |
| Find all physicians in zip 60201 | |||
| City | EVANSTON |
| Zip Code | 60201 |
| Specialty | PSYCHOLOGIST, CLINICAL |
| City + Specialty | EVANSTON + PSYCHOLOGIST, CLINICAL |
Please comment or provide details below to improve the information on Jerome P Wagner.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.