Provider Demographics
NPI:1902440969
Name:CEGERS, WANDA (APN)
Entity Type:Individual
Prefix:
First Name:WANDA
Middle Name:
Last Name:CEGERS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:MS
Other - First Name:WANDA
Other - Middle Name:
Other - Last Name:CEGERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSN, RN
Mailing Address - Street 1:400 N HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-3814
Mailing Address - Country:US
Mailing Address - Phone:630-892-4355
Mailing Address - Fax:
Practice Address - Street 1:400 N HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-3814
Practice Address - Country:US
Practice Address - Phone:630-892-4355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-03
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI108200163WN0300X, 2084P0800X
IL0413569732084P0800X, 163WN0300X
IL209022687363LP0808X
IN28233466A2084P0800X, 163WN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No163WN0300XNursing Service ProvidersRegistered NurseNephrology
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry