Individual
DR. JULIA BLAIZE WILKINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
036135153
IL
2086S0129X
Vascular Surgery Physician
Primary
036135153
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007692
—
LA
01
—
206147
MEDICARE GROUP PTAN
IL
01
—
F400163486
MEDICARE INDIVIDUAL
IL
Enumeration date
11/19/2007
Last updated
01/16/2015
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