Individual
DR. ELIZABETH JANIECE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1645 W JACKSON BLVD STE 400, CHICAGO, IL 60612-3244
(312) 563-9636
Mailing address
1645 W JACKSON BLVD, CHICAGO, IL 60612-3276
(312) 563-9636
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20043799B
IN
Other
Enumeration date
07/29/2024
Last updated
07/29/2024
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