Individual
DR. JUDY L WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1112 S WASHINGTON ST STE 112, NAPERVILLE, IL 60540-7960
(630) 717-9858
(630) 717-8259
Mailing address
805 GEORGETOWN DR, OSWEGO, IL 60543-6033
(630) 548-4819
(630) 717-8259
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2232446
BLUECROSSBLUE SHIELD PIN
IL
Enumeration date
08/28/2006
Last updated
07/08/2007
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