Individual
DR. JOHN R WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1440 W NORTH AVE STE 304, MELROSE PARK, IL 60160-1426
(708) 681-7879
(708) 681-7886
Mailing address
1440 W NORTH AVE STE 304, MELROSE PARK, IL 60160-1426
(708) 681-7879
(708) 681-7886
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
036088430
IL
2084N0600X
Clinical Neurophysiology Physician
036088430
IL
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
036088430
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036088430
—
IL
01
—
1635130
BCBS
IL
Enumeration date
11/22/2005
Last updated
07/30/2025
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