Individual
MARY E ILLIONS-WILDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4050 COON RAPIDS BLVD NW, COON RAPIDS, MN 55433-2522
(763) 236-6000
(763) 236-3433
Mailing address
321 N MALL DR STE B201, ST GEORGE, UT 84790-7310
(432) 222-0763
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
10132042-1205
UT
Other
Enumeration date
03/22/2006
Last updated
08/02/2022
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