Individual
MARY KATHERINE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
17800 KEDZIE AVE, HAZEL CREST, IL 60429-2029
(708) 213-4200
Mailing address
17800 KEDZIE AVE, HAZEL CREST, IL 60429-2029
(708) 213-4200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.012146
IL
Other
Enumeration date
08/06/2026
Last updated
08/06/2026
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