| Drs Wagner-debre Associates Sc | |
|
9830 Ridgeland Ave Suite 101 Chicago Ridge IL 60415-2667 | |
| (708) 423-3800 | |
| Not Available |
| Full Name | Drs Wagner-debre Associates Sc |
|---|---|
| Speciality | Internal Medicine |
| Location | 9830 Ridgeland Ave, Chicago Ridge, Illinois |
| Authorized Official Name and Position | Michael W Debre (SOLE OWNER (PRESIDENT)) |
| Authorized Official Contact | 7084233800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Drs Wagner-debre Associates Sc 9830 Ridgeland Ave Suite 101 Chicago Ridge IL 60415-2667 Ph: (708) 423-3800 | Drs Wagner-debre Associates Sc 9830 Ridgeland Ave Suite 101 Chicago Ridge IL 60415-2667 Ph: (708) 423-3800 |
| NPI Number | 1841474574 |
|---|---|
| Provider Enumeration Date | 12/17/2007 |
| Last Update Date | 12/29/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841474574 | NPI | - | NPPES |
| 36053268 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036053268 (Illinois) | Primary |
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