Individual
ROBIN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
842 S 18TH AVE, MAYWOOD, IL 60153-1706
(773) 849-5648
Mailing address
842 S 18TH AVE, MAYWOOD, IL 60153-1706
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043107846
IL
Other
Enumeration date
04/23/2020
Last updated
04/23/2020
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