Individual
SUSAN WILDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
4309 W MEDICAL CENTER DR, B310, MCHENRY, IL 60050-8419
(815) 344-0900
(815) 344-8957
Mailing address
3707 DOTY RD, SUITE G, WOODSTOCK, IL 60098-7530
(815) 206-1067
(815) 206-2804
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
—
IL
Other
Enumeration date
05/08/2006
Last updated
08/31/2007
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