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Individual

TAMARA D WILKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APN

Contact information

Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 624-8818
(309) 624-8820
Mailing address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 624-8818
(309) 624-8820

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209004304
IL

Other

Enumeration date
11/07/2011
Last updated
11/07/2011
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