Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Jerome Peter Wagner, PHD

Individual provider Clinical Psychologist · NPI 1487664850

Dr. Jerome Peter Wagner, PHD is a Clinical Psychologist in Evanston, Illinois. Graduated from Loyola University of Chicago, Stritch School of Medicine in 1981, 45 years ago. Practices as a sole proprietor, accepts Medicare assignment and offers telehealth. Licensed in Illinois.

Years since qualifying
45
Trained at
Loyola University of Chicago, Stritch School of Medicine
Licensed in
IL
In the registry since
2006
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

2603 Broadway Ave
Evanston, IL 60201-1501
Phone: (847) 492-1690
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X (IL)

Record details

NPI number1487664850
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorYes
NPI enumeratedAugust 9, 2006
Last updated in NPPESJuly 8, 2007
Mailing address2603 Broadway Ave, Evanston, IL 60201-1501

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolLOYOLA UNIVERSITY OF CHICAGO, STRITCH SCHOOL OF MEDICINE
Graduated 1981 (45 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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