Organization
MEDICAL SERVICE CORPORATION SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AGNES WILSON RN (RN)
(815) 252-1805
Entity
Organization
Contact information
Practice address
104 W 6TH ST STE 206, STREATOR, IL 61364-2864
(815) 252-1805
(815) 663-0103
Mailing address
405 BRONCO DR, BLOOMINGTON, IL 61704-5393
(815) 252-1805
(815) 663-0103
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
05/09/2013
Last updated
11/13/2013
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