ANNETTE M WAGNER MD
NPI 1477515807
Dermatology - Pediatric Dermatology in Westchester, IL

Q: What is Annette Wagner's NPI number?

The NPI number for Annette Wagner is 1477515807. It was assigned to this individual provider in the NPPES registry on April 3, 2006.

Q: What is Annette Wagner's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Pediatric Dermatology, with taxonomy code 207NP0225X.

Q: When was this NPI record last updated?

The NPPES record for Annette Wagner was last updated on September 21, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 03, 2006

2301 ENTERPRISE DRIVE, #81, WESTCHESTER, IL 60154(708) 836-4800(708) 836-4805 Get Directions Write a Review

NPPES record last updated: September 21, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Annette M Wagner Md NPPES

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

ANNETTE M WAGNER MD (NPI 1477515807) is an individual pediatric dermatology provider in Westchester, Illinois, licensed in Illinois (036089005) and active in the NPI registry since April 2006.

NPPES Registry Identity

NPI1477515807

Entity TypeIndividualFemale

Primary Taxonomy207NP0225X

Provider Legal NameANNETTE M WAGNERCredential: MD

Location Address2301 ENTERPRISE DRIVE, #81Westchester, IL 60154

Mailing Address2300 Children's Plaza, #107Chicago, IL 60614 · (312) 227-6060 · Fax (312) 227-9402

Phone(708) 836-4800

Fax(708) 836-4805

Sole ProprietorNo

Enumeration DateApril 3, 2006

Last NPPES UpdateSeptember 21, 2011

✔ NPI 1477515807 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · Pediatric DermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207NP0225X

License✔ Licensed in IL · 036089005

Definition

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.

2301 ENTERPRISE DRIVE, Westchester, IL 60154

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Other Identifiers 3

Medicare ID-Type UnspecifiedL33309IL

Medicare UPINF62985

Medicaid036089005IL

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 Annette Wagner's NPI number?

The NPI number for Annette Wagner is 1477515807. It was assigned to this individual provider in the NPPES registry on April 3, 2006.

Where is Annette Wagner located?

Annette Wagner practices at 2301 Enterprise Drive #81, Westchester, IL 60154. The listed phone number is (708) 836-4800.

What is Annette Wagner's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Pediatric Dermatology, with taxonomy code 207NP0225X.

When was this NPI record last updated?

The NPPES record for Annette Wagner was last updated on September 21, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.