Individual
MONICA M WILWERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1300 W 2ND ST, ROCK FALLS, IL 61071-1005
(815) 626-2230
(815) 626-6339
Mailing address
1300 W 2ND ST, ROCK FALLS, IL 61071-1005
(815) 626-2230
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
4358
ID
1223G0001X
General Practice Dentistry
Primary
019026652
IL
1223G0001X
General Practice Dentistry
08210
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019026652
IL STATE LICENSE
IL
01
—
08210
IA STATE LICENSE
IA
01
—
4358
STATE OF IDAHO LICENSE
ID
Enumeration date
09/21/2005
Last updated
07/21/2022
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