| 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 | Social Worker - Clinical | 
| Location | 3040 Finley Rd Ste 220, Downers Grove, Illinois | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1336926393 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149025667 (Illinois) | Primary | 
| 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  |