Wilford Tyrel Wagner, H.I.S

Primary specialty

Hearing Instrument SpecialistTaxonomy code 237700000X

License

3115 Issued in IL

Practice address

7317 N Harlem Ave
Niles, IL 60714-4252

Phone

(847) 588-1895

NPI assigned

Jun 12, 2013

Last updated

Aug 15, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Accuquest Hearing Center, LLC

  • Hearing and Speech Clinic/Center
  • Niles, IL
  • NPI 1437479128
  NPD (past)
• Accuquest Hearing Center, LLC

  • Hearing and Speech Clinic/Center
  • Somerset, NJ
  • NPI 1629261078

  Hearing Instrument Specialist

  NPD (past)

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

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565827200000",
    "number": "1689012684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7317 N HARLEM AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607144252",
            "telephone_number": "847-588-1895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7317 N HARLEM AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607144252",
            "telephone_number": "847-588-1895"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Verdae Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296073827",
            "country_code": "US",
            "telephone_number": "864-288-3113",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7317 N Harlem Ave",
            "address_purpose": "LOCATION",
            "city": "Niles",
            "state": "IL",
            "postal_code": "607144252",
            "country_code": "US",
            "telephone_number": "847-588-1895",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "WILFORD",
        "middle_name": "TYREL",
        "credential": "H.I.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-12",
        "last_updated": "2019-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "SC",
            "license": "HAS-0516",
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "IL",
            "license": "3115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Visionworks, Inc. (Visionworks)
• Vital Link Physician Group PLLC
• Jill Marie Waegenaere, M.A.
• Krystyna Wagenhejm-Ciesielski
• Lida Wagner, LCSW
• Bethany Wagreich, M.A., CCC-SLP
• Wal-Mart Stores, Inc (Vision Center 30-2816)
• Wal-Mart Stores, Inc. (Vision Center 30-3725)
• Monika Walaszek
• Walgreen Co (Walgreens #02721)

• Hearing Instrument Specialist in Niles, IL
• Providers in Niles, IL by specialty
• Hearing Instrument Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.