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Individual

MR. MATTHEW TODD WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ACNS-BC, APN

Contact information

Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2000
(309) 655-7869
Mailing address
102 N 3RD ST, WYOMING, IL 61491-1223
(309) 606-3152

Taxonomy

Speciality
Code
Description
License number
State
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
209.008422
IL

Other

Enumeration date
10/21/2010
Last updated
10/21/2010
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