Individual
MRS. LUCY NELSON WISDOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1404 EASTLAND DRIVE, SUITE 204, BLOOMINGTON, IL 61701
(309) 662-8813
(309) 662-6835
Mailing address
1404 EASTLAND DRIVE, SUITE 204, BLOOMINGTON, IL 61701
(309) 662-8813
(309) 662-6835
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036110740
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036110740
—
IL
Enumeration date
02/02/2007
Last updated
07/08/2007
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us