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SHY L WAGONER CST
NPI 1164655452
in Springfield, IL

Active since September 02, 2009
2921 MONTVALE DR, SPRINGFIELD, IL 62704(217) 787-2700(217) 787-2715 Get Directions Write a Review

NPPES record last updated: February 17, 2012. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Shy L Wagoner Cst NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHY L WAGONER CST (NPI 1164655452) is an individual healthcare provider in Springfield, Illinois and active in the NPI registry since September 2009.

NPPES Registry Identity

NPI1164655452
Entity TypeIndividualFemale
Primary Taxonomy246ZS0400X
Provider Legal NameSHY L WAGONERCredential: CST
Location Address2921 MONTVALE DRSpringfield, IL 62704-5359
Mailing Address2921 Montvale DrSpringfield, IL 62704-5359 · (217) 787-2700 · Fax (217) 787-2715
Phone(217) 787-2700
Fax(217) 787-2715
Sole ProprietorYes
Enumeration DateSeptember 2, 2009
Last NPPES UpdateFebruary 17, 2012
✔ NPI 1164655452 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary Specialty
Taxonomy Code246ZS0400X
2921 MONTVALE DR, Springfield, IL 62704
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Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SPRINGFIELD NEUROSURGICAL ASSOCAITES, S.C.
Surgery
2921 MONTVALE DR
SPRINGFIELD, IL 62704
Sangamon County (217) 793-9600
PATRICIA ANN DENNISON
Specialist/Technologist, Other (Surgical Assistant)
2921 MONTVALE DR
SPRINGFIELD, IL 62704
Sangamon County (217) 787-2700
JOHN M SIGLE DPM
Podiatrist (Primary Podiatric Medicine)
2921 MONTVALE DR
SPRINGFIELD, IL 62704
Sangamon County (217) 793-9600
DR. GRANT WILSON GONZALEZ D.P.M.
Podiatrist (Foot & Ankle Surgery)
2921 MONTVALE DR
SPRINGFIELD, IL 62704
Sangamon County (217) 787-2700
FOOT & ANKLE CENTER OF ILLINOIS PC
Podiatrist (Primary Podiatric Medicine)
2921 MONTVALE DR
SPRINGFIELD, IL 62704
Sangamon County (217) 787-2700

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shy Wagoner's NPI number?

The NPI number for Shy Wagoner is 1164655452. It was assigned to this individual provider in the NPPES registry on September 2, 2009.

Where is Shy Wagoner located?

Shy Wagoner practices at 2921 Montvale Dr, Springfield, IL 62704. The listed phone number is (217) 787-2700.

When was this NPI record last updated?

The NPPES record for Shy Wagoner was last updated on February 17, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.