Individual
DR. DAVID B. WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 CORPORATE GROVE DR, BUFFALO GROVE, IL 60089-4550
(224) 588-9940
(224) 588-9941
Mailing address
1359 BARCLAY BLVD, BUFFALO GROVE, IL 60089-4501
(224) 588-9940
(224) 588-9941
Taxonomy
Speciality
Code
Description
License number
State
207ZH0000X
Hematology (Pathology) Physician
01049186A
IN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
01049186A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000014566
MPLAN
IN
01
—
000000191567
ANTHEM
IN
05
—
200329070A
—
IN
Enumeration date
12/30/2005
Last updated
06/30/2023
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