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Carolyn Wagner
Mental Health Clinic/Center (Including Community Mental Health Center) in Wilmette, Illinois
NPI 1164047072

Carolyn Wagner is a Mental Health Clinic/Center (Including Community Mental Health Center) based in Wilmette, IL and is specialized in Mental Health (Including Community Mental Health Center). Carolyn Wagner practices in Wilmette, IL. The NPI Number for Carolyn Wagner is 1164047072 and holds a License No. (Illinois).

The current practice location address for Carolyn Wagner is 1159 Wilmette Ave Ste 225, Wilmette, IL and can be reached out via phone at 847-728-8148.

Location: 1159 Wilmette Ave Ste 225, Wilmette, IL, 60091-2653
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1164047072
Provider Name
Carolyn Wagner
Credential
Provider Entity Type
Organization
Address
1159 Wilmette Ave Ste 225, Wilmette, IL, 60091-2653
Phone Number
847-728-8148
Fax Number
Provider Enumeration Date
06/16/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1159 Wilmette Ave Ste 225
City
Wilmette
State
Illinois
Zip
60091-2653
Phone Number
847-728-8148
Fax Number
person
Provider Business Mailing Address Details
Address
1159 Wilmette Ave Ste 225
City
Wilmette
State
Illinois
Zip
60091-2653
Phone Number
847-728-8148
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
261QM0801X
License No.
()
Definition
Definition to come...
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