RICHARD WAGER (NPI# 1912989252) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912989252 |
| Entity Type | Individual |
| Full Name | RICHARD WAGER |
| Credential | PHYSICAL THERAPIST |
| Practice Address |
2346 Mascoutah Ave Belleville IL 62220-3499 |
| Practice Telephone | 6182776282 |
| Practice Fax Number | 6182776284 |
| Mailing Telephone | 6182776282 |
| Mailing Fax Number | 6182776284 |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2016-07-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251S0007X |
Physical Therapist Specialization: Sports |
070004745 | IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
096000735 | IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
2346 MASCOUTAH AVE |
| City | BELLEVILLE |
| State | IL |
| Zip Code | 62220-3499 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104170356 | Eric Rolves | Specialist/Technologist | 2346 Mascoutah Ave, Belleville, IL 62220-3499 | 2012-11-08 |
| 1972708253 | Daniel Musenbrock | Physical Therapist | 2346 Mascoutah Ave, Belleville, IL 62220-3499 | 2007-06-18 |
| 1992874416 | Athletic Therapy Center, P.C. | Physical Therapist | 2346 Mascoutah Ave, Belleville, IL 62220-3499 | 2006-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144729716 | St. Elizabeth's Hospital of The Hospital Sisters of The Third Order Of | Clinic/Center | 180 South Third Street Suite 101, Belleville, IL 62220 | 2018-02-08 |
| 1437675535 | Prorehab PC | Occupational Therapist | 1915 Carlyle Ave, Ste D, Belleville, IL 62220 | 2017-08-21 |
| 1629527650 | Arika Forrest | Nurse Practitioner | 140 Iowa Ave, Belleville, IL 62220 | 2016-10-03 |
| 1861861403 | Belleville Endoscopy LLC | Internal Medicine | 311 West Lincoln St, Suite 101, Belleville, IL 62220 | 2015-09-24 |
| 1962871558 | Antony Frierdich | Specialist/Technologist | 22 South 13th Street, Belleville, IL 62220 | 2015-09-24 |
| 1588032858 | Dana Wright | Pharmacist | 211 South Thrid Street, Belleville, IL 62220 | 2015-09-03 |
| 1629208731 | Lisa Marlow Johnson | Developmental Therapist | 34 Fenwood Dr, Belleville, IL 62220 | 2009-07-23 |
| 1841361623 | Neurological Surgery of Belleville | Neurological Surgery | 340 West Lincoln Street, Suite 540, Belleville, IL 62220 | 2006-11-13 |
| 1689769119 | Kathy Jo Corn | Counselor | 521 W. Main, Suite 201 B, Belleville, IL 62220 | 2006-10-03 |
| 1780609578 | Southern Illinois Health Care Foundation, Inc. | Counselor | 180 S 3rd St Ste 103&104, Belleville, IL 62220 | 2006-07-13 |
| Find all providers in zip 62220 | ||||
| Taxonomy Code | 2251S0007X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Sports |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336760529 | Max Whiting | Physical Therapist | 711 W Maxwell St, Chicago, IL 60607-5016 | 2020-04-29 |
| 1043830540 | Natalie Johanna Farah | Physical Therapist | 123 W Madison St Ste 200, Chicago, IL 60602-4632 | 2020-04-24 |
| 1316185168 | Brian Cunningham | Physical Therapist | 417 Glenview Rd, Glenview, IL 60025-3262 | 2009-02-02 |
| 1700046315 | Michelle Marie Bettuzzi | Physical Therapist | 1021 Vine Ave, Park Ridge, IL 60068-4855 | 2008-06-17 |
| 1275706368 | Physically Phit | Physical Therapist | 2320 N Damen Ave Ste 1r, Chicago, IL 60647-3359 | 2008-04-09 |
| 1184830812 | Jeremy Smith | Physical Therapist | 1920 Football Dr, Lake Forest, IL 60045-4829 | 2007-05-16 |
| 1386868701 | Eryn Kubinski | Physical Therapist | 115 Republic Ave, Joliet, IL 60435-6570 | 2007-04-13 |
| 1720166655 | Gregory Given | Physical Therapist | 407 E Terra Cotta Ave Ste E, Crystal Lake, IL 60014-3602 | 2006-11-01 |
| 1215545249 | Lauren Wiske | Physical Therapist | 6524 W Archer Ave, Chicago, IL 60638-2400 | 2020-07-15 |
| 1811533953 | United Methodist Homes and Services | Physical Therapist | 439 Bohland Ave, Bellwood, IL 60104 | 2019-11-25 |
| Find all providers with the same taxonomy | ||||
| City | BELLEVILLE |
| Zip Code | 62220 |
Please comment or provide details below to improve the information on RICHARD WAGER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.