Individual
DARA ELIZABETH WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1111 W DIVERSEY PKWY, CHICAGO, IL 60614-1318
(773) 270-5600
Mailing address
1111 W DIVERSEY PKWY, CHICAGO, IL 60614-1318
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209023882
IL
Other
Enumeration date
09/20/2021
Last updated
09/20/2021
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