Wagle, Archana G

Wagle, Archana G is an sole proprietor health care provider with primary practice located at 2701 17Th St , Rock Island IL 61201-5351. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Interventional Pain Medicine. Allopathic & Osteopathic Physicians / Interventional Pain Medicine is her primary health care specialty. Wagle, Archana G can be contacted via phone (309) 779-5000.

Contact Information

Primary practice address
2701 17Th St Rock Island IL 61201-5351
Phone: (309) 779-5000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 036100676 Illinois
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X 036100676 Illinois
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X 036100676 Illinois

Profile Details

NPI number 1366421968
LBN Legal business name Wagle, Archana G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 11th, 2006
Last updated Aug 16th, 2023 - about last year

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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Identifiers

StateTypeNumberIssuer
All States NPI 1366421968 NPPES
Illinois MEDICAID 036100676
Illinois MEDICAID 0546036

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