Paula J Wagner, APN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209008086 Issued in IL

Practice address

6150 N Broadway St
Chicago, IL 60660

Phone

(866) 389-2727

NPI assigned

Jul 19, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1279497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548547200000",
    "number": "1124331152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6150 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606602538",
            "telephone_number": "866-389-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6150 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60660",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11200 Lincoln Hwy",
            "address_purpose": "LOCATION",
            "city": "Mokena",
            "state": "IL",
            "postal_code": "604488208",
            "country_code": "US",
            "telephone_number": "312-343-1398",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "PAULA",
        "middle_name": "J",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-19",
        "last_updated": "2019-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209008086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Wagner
• Lynne I. Wagner, PH.D.
• Mary Kathleen Wagner, LCSW CADC
• Maximilian Wagner
• Olivia Wagner, RDN, LDN
• Regina E Wagner, RPH
• Stephanie Wagner, MD
• Tanya Wagner, FNP-C
• Ursula Wagner, LCSW
• Sarah Fredrica Wagoner, MD, MPH

• Family Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.