| Brian Joseph Wagner, LCSW | |
|
55 E Loop Rd Ste 301, Wheaton, IL 60189-1938 | |
| (630) 428-7890 | |
| (630) 428-7891 |
| Full Name | Brian Joseph Wagner |
|---|---|
| Gender | Male |
| Speciality | Clinical Social Worker |
| Experience | 8 Years |
| Location | 55 E Loop Rd Ste 301, Wheaton, 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 Joseph Wagner, LCSW 55 E Loop Rd Ste 301, Wheaton, IL 60189-1938 Ph: (630) 428-7890 | Brian Joseph Wagner, LCSW 55 E Loop Rd Ste 301, Wheaton, IL 60189-1938 Ph: (630) 428-7890 |
Kathryn P Bach, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1608 Cavalier Ct, Wheaton, IL 60189 Phone: 630-561-6070 | |
Mark Charles Macdonald, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 600 W Roosevelt Rd, Suite A2, Wheaton, IL 60187 Phone: 630-462-8810 Fax: 630-462-8820 | |
Mrs. Molly Alice Ryan Wollenweber, LCSW, CADC Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 128 S County Farm Rd Ste C, Wheaton, IL 60187 Phone: 630-423-2350 | |
Mr. Kenton James Withrow, LCSW, CADC Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1530 N Main St, Wheaton, IL 60187 Phone: 630-653-6400 Fax: 630-653-6490 | |
Mrs. Kelly Elizabeth Reilly, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 112 N Erie St, Wheaton, IL 60187 Phone: 630-518-1545 | |
Randolph Paul Andersen, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 128 S County Farm Rd Ste C, Wheaton, IL 60187 Phone: 630-447-8818 | |
Melissa Aguirre Jenkins, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 222 E Willow Ave, Wheaton, IL 60187 Phone: 630-784-4840 |