Individual
MR. WILSON JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
5145 N CALIFORNIA AVE, CHICAGO, IL 60625-3661
(773) 878-8200
Mailing address
6729 CHURCH ST, MORTON GROVE, IL 60053-2307
(847) 501-0035
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.001586
IL
Other
Enumeration date
07/22/2008
Last updated
07/22/2008
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