| Mrs Jennifer Lee Wagoner, PT | |
|
505 E Grant St, Macomb, IL 61455-3352 | |
| (309) 833-1733 | |
| Not Available |
| Full Name | Mrs Jennifer Lee Wagoner |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist In Private Practice |
| Experience | 18 Years |
| Location | 505 E Grant St, Macomb, Illinois |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861785206 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 070015942 (Illinois) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Springfield Clinic, Llp | 0547166076 | 655 |
| Provider Name | Springfield Clinic, Llp |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1780638478 PECOS PAC ID: 0547166076 Enrollment ID: O20040331000826 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Jennifer Lee Wagoner, PT 1025 S 6th St, Springfield, IL 62703-2403 Ph: (217) 528-7541 | Mrs Jennifer Lee Wagoner, PT 505 E Grant St, Macomb, IL 61455-3352 Ph: (309) 833-1733 |
Holly Nicole Clauson, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 130 S Lafayette St Ste 201, Macomb, IL 61455 Phone: 309-837-3911 | |
Victor Erude Lidaywa, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1701 W Jackson St, Ste C, Macomb, IL 61455 Phone: 309-331-3590 | |
Dana Peacock, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 525 E Grant St, Macomb, IL 61455 Phone: 309-836-1601 | |
Advanced Physical Therapy Services, Ltd. Physical Therapist Medicare: Medicare Enrolled Practice Location: 130 S Lafayette St, Suite A, Macomb, IL 61455 Phone: 309-836-2500 Fax: 309-836-2501 | |
Jordan Fink, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 130 S Lafayette St, Macomb, IL 61455 Phone: 309-836-2500 Fax: 309-836-2501 | |
Alana Hendrixson, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 505 E Grant St Ste 110, Macomb, IL 61455 Phone: 217-528-7541 |