OrganizationActive
E. Wagner'S Shoes
NPI 1104983337 · Prosthetic/Orthotic Supplier · River Forest, IL
E. Wagner'S Shoes is a Prosthetic/Orthotic Supplier organization in River Forest, IL (NPI 1104983337).
Provider details
- NPI number
- 1104983337
- Entity type
- Organization
- Primary specialty
- Prosthetic/Orthotic SupplierSuppliers
- Organization subpart
- No
- Authorized official
- Jerry Stout, Owner(708) 771-4528
- License
- 0887330001 (IL)
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
7379 North Ave
River Forest, IL 60305-1230
Phone: (708) 771-4528
Street-level locationGet directions
Mailing address
7379 North Ave
River Forest, IL 60305-1230
Registry dates
- Enumerated
- 2007-01-03
- Last updated
- 2008-12-17
Frequently asked questions
- What is E. Wagner'S Shoes's NPI number?
- E. Wagner'S Shoes's National Provider Identifier (NPI) is 1104983337, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is E. Wagner'S Shoes?
- E. Wagner'S Shoes is classified in the NPPES registry as Prosthetic/Orthotic Supplier (Suppliers).
- Where is E. Wagner'S Shoes located?
- E. Wagner'S Shoes's practice location on file with NPPES is 7379 North Ave, River Forest, IL 60305-1230.
- What is E. Wagner'S Shoes's phone number?
- The practice phone number listed in the NPPES registry for E. Wagner'S Shoes is (708) 771-4528.
- Who is the authorized official for E. Wagner'S Shoes?
- The authorized official listed on E. Wagner'S Shoes's NPPES record is Jerry Stout, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is E. Wagner'S Shoes's NPI active?
- Yes — E. Wagner'S Shoes's NPI (1104983337) is active in the NPPES registry as of the last update on 2008-12-17.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.