Active NPI
Wendy Lynn Wagner, MPT
- Physical Therapist
- Naperville, IL
National Provider Identifier
1093025371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070011118
- Practice address
- 308 Senna CT
Naperville, IL 60565-1358 - Phone
- (630) 428-3022
- Fax
- (630) 428-3025
- NPI assigned
- Oct 20, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070011118 | IL | Primary |
Addresses
Primary practice location
308 Senna CT
Naperville, IL 60565-1358
Mailing address
308 Senna CT
Naperville, IL 60565-1358
Phone (630) 428-3022
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070011118 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287532800000",
"number": "1093025371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "308 SENNA CT",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605651358",
"telephone_number": "630-428-3022",
"fax_number": "630-428-3025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "308 SENNA CT",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605651358",
"telephone_number": "630-428-3022",
"fax_number": "630-428-3025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "WENDY",
"middle_name": "LYNN",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-20",
"last_updated": "2010-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070011118",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Naperville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.