Individual
CARRIE C. WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6801 S BENNETT AVE, CHICAGO, IL 60649-1501
(312) 341-9373
Mailing address
6801 S BENNETT AVE, CHICAGO, IL 60649-1501
(312) 341-9373
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036-055269
IL
Other
Enumeration date
08/28/2006
Last updated
11/20/2009
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