Individual
KANE WILBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
902 W MAIN ST, WEST FRANKFORT, IL 62896-2210
(618) 937-6483
Mailing address
902 W MAIN ST, WEST FRANKFORT, IL 62896-2210
(618) 937-6483
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.102613
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
370916475048
—
IL
Enumeration date
09/05/2017
Last updated
07/21/2022
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