Waggoner, Darrel
Waggoner, Darrel is an individual health care provider with primary practice located at 5841 S Maryland Ave , Chicago IL 60637-1443. He recently has only one registered license in Allopathic & Osteopathic Physicians / Clinical Genetics (M.D.), which is considered as his primary health care specialty. Waggoner, Darrel can be contacted via phone (888) 824-0200.Contact Information
Primary practice address
5841 S Maryland Ave
Chicago IL 60637-1443
Phone: (888) 824-0200
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Clinical Genetics (M.D.) | 207SG0201X | 036090276 | Illinois |
Profile Details
| NPI number | 1669595872 |
|---|---|
| LBN Legal business name | Waggoner, Darrel |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 10th, 2007 |
| Last updated | Oct 24th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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