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E. Wagner'S Shoes — NPI 1104983337, River Forest, IL | NPI Central

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E. Wagner'S Shoes

NPI 1104983337 · Prosthetic/Orthotic Supplier · River Forest, IL

Provider details

NPI number: 1104983337
Entity type: Organization
Primary specialty: Prosthetic/Orthotic SupplierSuppliers
Authorized official: Jerry Stout, Owner
License: 0887330001 (IL)

Practice location

7379 North Ave

River Forest, IL 60305-1230

Phone: (708) 771-4528

More IL providers

Mailing address

7379 North Ave

River Forest, IL 60305-1230

Registry dates

Enumerated: 2007-01-03
Last updated: 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.