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ROBERT WAGNER MD NPI 1154308039


NPI Information

NPI: 1154308039
Provider Name: ROBERT WAGNER, MD
Classification: Radiology - 2085N0904X
Entity Type: Individual

Specialization: Nuclear Radiology

Organization: LOYOLA UNIVERSITY MEDICAL CENTER

PECOS Registration: Yes

Address:
2160 S 1ST AVE
(MCGAW ENT., RM 47)
MAYWOOD, IL
ZIP 60153
Phone: (708) 216-5221
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Robert Wagner, MD is a nuclear radiology radiology in Maywood, IL with 40 years of experience. The provider is a radiologist who is involved in the analysis and imaging of radionuclides and radiolabeled substances in vitro and in vivo for diagnosis and the administration of radionuclides and radiolabeled substances for the treatment of disease. Robert Wagner, MD NPI is 1154308039. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: RUSH MEDICAL COLLEGE OF RUSH UNIVERSITY
Graduation Year:1984

The provider's business location address is:

2160 S 1ST AVE
(MCGAW ENT., RM 47)
MAYWOOD, IL
ZIP 60153
Phone: (708) 216-5221
Fax: (708) 216-0899

The NPI 1154308039 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Nuclear medicine study of vessels of heart using drugs or exercise multiple studies (HCPCS:78452)
  • Bone and/or joint imaging, whole body (HCPCS:78306)
  • Nuclear medicine study with CT imaging skull base to mid-thigh (HCPCS:78815)
  • Nuclear medicine study of lung ventilation and blood circulation in the lungs (HCPCS:78582)
  • Nuclear medicine study with CT imaging whole body (HCPCS:78816)

The enumeration date for this NPI number is 12/30/2005 and was last updated on 4/23/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12085N0904XRadiologyNuclear Radiology36071977ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
136071977MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.