Individual
DR. BRENT WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1640 W ROOSEVELT RD, CHICAGO, IL 60608-1316
(312) 355-8305
(312) 413-8333
Mailing address
1640 W ROOSEVELT RD, CHICAGO, IL 60608-1316
(312) 355-8305
(312) 413-8333
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
070.025455
IL
Other
Enumeration date
12/17/2020
Last updated
01/11/2021
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