| Brian Wagner, LCSW | |
|
3040 Finley Rd Ste 220, Downers Grove, IL 60515-5714 | |
| (877) 381-6538 | |
| Not Available |
| Full Name | Brian Wagner |
|---|---|
| Gender | Male |
| Speciality | Clinical Social Worker |
| Experience | 7 Years |
| Location | 3040 Finley Rd Ste 220, Downers Grove, Illinois |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336926393 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149025667 (Illinois) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Otte Practice Pllc | 6608231097 | 3 |
| Entity Name | Otte Practice Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477279651 PECOS PAC ID: 6608231097 Enrollment ID: O20230509001058 |
| Mailing Address | Practice Location Address |
|---|---|
| Brian Wagner, LCSW 55 E Jackson Blvd, Chicago, IL 60604-4466 Ph: () - | Brian Wagner, LCSW 3040 Finley Rd Ste 220, Downers Grove, IL 60515-5714 Ph: (877) 381-6538 |
Laurel C Bonk, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1401 Branding Ave Ste 345, Downers Grove, IL 60515 Phone: 331-254-4464 | |
Mr. Edward Neil Klama, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 5715 Lomond Ave, Downers Grove, IL 60516 Phone: 630-963-5749 | |
Marissa N Pezzulo, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3040 Finley Rd Ste 220, Downers Grove, IL 60515 Phone: 877-381-6538 Fax: 708-859-0166 | |
Emily Carrier, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3500 Lacey Rd, Downers Grove, IL 60515 Phone: 312-653-7194 | |
Sandra Monarrez, LSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1035 Havens Ct, Downers Grove, IL 60515 Phone: 630-296-4427 | |
Rebecca Doyle, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2901 Finley Rd, Ste. 101, Downers Grove, IL 60515 Phone: 630-792-1800 Fax: 630-792-1801 | |
Mrs. Tania M Yackle, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 900 Ogden Ave Ste 144, Downers Grove, IL 60515 Phone: 630-474-1257 |