ANNETTE M. WAGNER MD – NPI #1477515807
Dermatology

A pediatric dermatologist has, through additional special training, developed expertise in the treatment of specific skin disease categories with emphasis on those diseases which predominate in infants, children and adolescents.

ANNETTE WAGNER is a dermatologist located in WESTCHESTER, IL. NPPES has assigned the NPI number 1477515807 to ANNETTE WAGNER on April 03, 2006. It is a Type-1 NPI, indicating this NPI number is associated with an individual. The primary taxonomy selected by this provider is 207NP0225X from the Health Care Provider Taxonomy code set, which is classified as Dermatology, specializing in Pediatric Dermatology

The NPI profile was previously updated about 15 years ago on Sep 21, 2011. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ANNETTE WAGNER below.

NPI Profile for
ANNETTE M. WAGNER

NPI Number
1477515807
Enumeration Date

(more than 20 years ago)
Entity Type
Type-1  Individual (Female)
Legal Name
ANNETTE M. WAGNER
Credentials
MD
Primary location
2301 ENTERPRISE DRIVE
#81
WESTCHESTER, IL 60154
Phone: (708) 836-4800 Fax: (708) 836-4805
Mailing address
2300 CHILDREN'S PLAZA
#107
CHICAGO, IL 60614
Phone: (312) 227-6060 Fax: (312) 227-9402
Sole Proprietor
No
Updated
Identifiers

Identifiers for ANNETTE WAGNER

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDIL036089005
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207NP0225X
- Dermatology / Pediatric Dermatology (Primary)
IL 036089005

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.