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

Lisa Wagner

Individual provider Developmental Therapist · NPI 1114693587

Lisa Wagner is a Developmental Therapist in Chicago, Illinois. Practices as a sole proprietor. Registered with an NPI since 2021.

In the registry since
2021

Practice location Address checks out

706 W 17th St Apt 2F
Chicago, IL 60616-1220
Phone: (630) 709-8252
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Developmental Therapist (primary) Taxonomy 222Q00000X

Record details

NPI number1114693587
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedAugust 17, 2021
Last updated in NPPESAugust 17, 2021
Certification dateAugust 17, 2021
Mailing address706 W 17th St Apt 2f, Chicago, IL 60616-1220

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