ALAN S. WAGNER M.D. NPI 1497701684

NPI Information

  • NPI: 1497701684
  • Provider Name: ALAN S. WAGNER, M.D.
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3849 N PERRYVILLE RD
    ROCKFORD, IL
    ZIP 61114
  • Phone: (815) 397-5554

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NPI Details

Alan S. Wagner, M.D. is a diagnostic radiology radiology in Rockford, IL. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. Alan S. Wagner, M.D. NPI is 1497701684. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3849 N PERRYVILLE RD
ROCKFORD, IL
ZIP 61114-080
Phone: (815) 397-5554
Fax: (866) 914-7534

The NPI 1497701684 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 5/26/2006 and was last updated on 5/19/2011.

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
12085R0202XRadiologyDiagnostic Radiology36-099687ILLINOISYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1H09829MEDICARE UPINILLINOIS
2L75829MEDICARE ID-TYPE UNSPECIFIEDILLINOIS
3036099687MEDICAIDILLINOIS

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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