TANYA WAGNER FNP-C NPI 1043091861

NPI Information

  • NPI: 1043091861
  • Provider Name: TANYA WAGNER, FNP-C
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 200 E 75TH ST STE 200
    CHICAGO, IL
    ZIP 60619
  • Phone: (872) 231-4100

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NPI Details

Tanya Wagner, FNP-C is a family nurse practitioner in Chicago, IL. Tanya Wagner, FNP-C NPI is 1043091861. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

200 E 75TH ST STE 200
CHICAGO, IL
ZIP 60619-280
Phone: (872) 231-4100

The NPI 1043091861 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 enumeration date for this NPI number is 10/9/2023 and was last updated on 5/1/2024.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily209028368ILLINOISYes

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: 11/21/2025

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