Individual
MS. MARA D WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2003 W FULTON ST # 303, CHICAGO, IL 60612-2345
(312) 243-2223
Mailing address
2003 W FULTON ST # 303, CHICAGO, IL 60612-2345
(312) 243-2223
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209021998
IL
Other
Enumeration date
10/02/2020
Last updated
10/10/2023
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