IndividualActive
Steven Wagner
NPI 1679460778 · Pharmacist · Washington Park, IL
Provider details
- NPI number
- 1679460778
- Entity type
- Individual
- Primary specialty
- PharmacistPharmacy Service Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- 051031829 (IL)
Specialties & taxonomies
Pharmacy Service Providers
Profile Score
Established profile(54/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in 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
1833 Kingshighway
Washington Park, IL 62204
Phone: (618) 874-3000
Fax: (618) 674-3103
Street-level locationGet directions
Mailing address
1833 Kingshighway
East Saint Louis, IL 62204-2135
Registry dates
- Enumerated
- 2025-06-20
- Last updated
- 2025-06-20
- Certified
- 2025-06-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.