Jack Wagoner, MD
Jack Wagoner, MD is a General Surgery in Sycamore, Illinois. Graduated from Southern Illinois University School of Medicine in 1993, 33 years ago. Practices with Central Dupage Physician Group, a 1,094-clinician group and accepts Medicare assignment. Licensed in Illinois.
- Years since qualifying
- 33
- Trained at
- Southern Illinois University School of Medicine
- Licensed in
- IL
- In the registry since
- 2006
What do these letters mean?
- MD — Doctor of Medicine
- A physician who completed allopathic medical school.
Practice location Address checks out
1850 Gateway DrSycamore, IL 60178-3192
Phone: (815) 758-8671
Fax: (815) 758-5610
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Surgery Physician (primary) | Taxonomy 208600000X · Licence 036-100314 (IL) |
|---|
Record details
| NPI number | 1518979665 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | MD |
| Sole proprietor | No |
| NPI enumerated | August 13, 2006 |
| Last updated in NPPES | June 11, 2012 |
| Mailing address | 1850 Gateway Dr, Sycamore, IL 60178-3192 |
Medicare enrollment
| Medicare specialty | GENERAL SURGERY |
|---|---|
| Medical school | SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE |
| Graduated | 1993 (33 years in practice) |
| Group practice | Central Dupage Physician Group — 1094 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
Other providers in Sycamore
-
Stephen Goldman, MD
1850 Gateway Dr, Sycamore, IL 60178-3192 · (815) 758-8671
-
Nitzet Velez, MD
1850 Gateway Dr, Sycamore, IL 60178-3192 · (815) 758-8671