| Heidi Wagner, | |
|
545 Plainfield Rd Ste G-1, Willowbrook, IL 60527-7600 | |
| (708) 405-8025 | |
| (763) 205-9350 |
| Full Name | Heidi Wagner |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 545 Plainfield Rd Ste G-1, Willowbrook, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447702147 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 209014217 (Illinois) | Primary |
| Entity Name | Moments Palliative Care Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972290724 PECOS PAC ID: 0143561480 Enrollment ID: O20230621000073 |
| Mailing Address | Practice Location Address |
|---|---|
| Heidi Wagner, 545 Plainfield Rd Ste G-1, Willowbrook, IL 60527-7600 Ph: (630) 205-0101 | Heidi Wagner, 545 Plainfield Rd Ste G-1, Willowbrook, IL 60527-7600 Ph: (708) 405-8025 |
Patricia Kuenzi, ANP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 535 Plainfield Rd, Willowbrook, IL 60527 Phone: 630-986-7501 | |
Marie Rochelle Gonzalo Wauna, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 40 75th St, Willowbrook, IL 60527 Phone: 630-581-5372 | |
Irma Dondiego, FNP-BC, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 40 75th St, Willowbrook, IL 60527 Phone: 630-581-5372 | |
Dana Clayter, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 40 75th St, Willowbrook, IL 60527 Phone: 630-400-4060 | |
Vanessa Diaz Cloud, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 535 Plainfield Rd Ste D, Willowbrook, IL 60527 Phone: 630-277-9018 Fax: 866-531-8584 | |
Valbona Capani, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 40 75th St, Willowbrook, IL 60527 Phone: 630-581-5372 | |
Joanna Czmiel, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 40 75th St, Willowbrook, IL 60527 Phone: 630-581-5372 |