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Individual

ANTHONY D WILKO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
5454 HOHMAN AVE, HAMMOND, IN 46320-1931
(219) 933-2077
(219) 864-2649
Mailing address
PO BOX 1000, DYER, IN 46311-0800
(219) 864-2107
(219) 864-2649

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
02001473A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036086592
IL
05
100345860
IN
01
90001358
BCBSIL
IL
Enumeration date
09/14/2005
Last updated
07/20/2011
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