Individual
JANICE SHIGEKO WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3001 GREEN BAY RD, NORTH CHICAGO, IL 60064-3048
(224) 610-3871
(224) 610-2958
Mailing address
216 W PARK ST, MUNDELEIN, IL 60060-1747
(847) 566-2882
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
85000265
IL
Other
Enumeration date
08/16/2006
Last updated
07/08/2007
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