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Next Update: Thursday, December 19, 2024 2:50 AM CST
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WAGNER, ANDREW FREDERICK
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This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
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| Practice Address: |
250 E. SUPERIOR STREET
SUITE 05-2175
CHICAGO IL 60611
Address last updated on 6/3/2024 |
| Phone #: |
(312) 472-1790 x3124 |
| Fax #: |
(312) 472-0511 |
| County: |
NOT OKLAHOMA |
| License: |
24431 |
| Dated: |
6/24/2005 |
| Expires: |
6/1/2025 |
| License Type: |
Medical Doctor |
| Specialty: |
Obstetrics & Gynecology
Medical Genetics |
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| Status: |
Active |
| Status Class: |
Fully Licensed |
| Restricted to: |
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| Registered to Dispense: |
NO |
| Medical School: |
Univ of WI Sch of Med & Public Hlth, Madison, WI |
| Graduated: |
5 /
1999 |
| CME Year: |
2026 |
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Pending and/or Past Disciplinary Actions:
No Disciplinary Action Taken.
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All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
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| Certifications: |
AMERICAN BOARD OF MEDICAL GENETICS (Clinical Genetics)
AMERICAN BOARD OF OBSTETRICS AND GYNECOLOGY |
| New Patients: |
Yes |
| Medicaid: |
Yes |
| Medicare: |
Yes |
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| HMO/PPO: |
Aetna Elect Choice
Aetna HMO
Aetna Managed Choice
Aetna PPO
Blue Cross Blue Shield-Blue Preferred
Blue Cross Blue Shield-Blue Traditional
Blue Cross Blue Shield-Plan 65 Select
BlueChoice PPO
BlueLincs HMO
CIGNA PPO
CommunityCare HMO, Inc
Evolutions Healthcare
First Health
HealthChoice
Humana Tricare/PGBA
OSMA Health (formerly Plico PPO)
PacifiCare of Oklahoma, Inc
Physicians Direct Network
PPO USA
Railroad Medicare
Secure Horizons HMO
SoonerCare HMO
United Healthcare Choice
United Healthcare EPO
United Healthcare HMO
United Healthcare Options PPO
United Healthcare POS |
| Hospital Privileges: |
Hospital(s) Not In Oklahoma
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