Wilson, John R

Wilson, John R is an individual health care provider with primary practice located at 1S443 Summit Ave Suite# 203, Oakbrook Terrace IL 60181-3989. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurology, Allopathic & Osteopathic Physicians / Clinical Neurophysiology, Allopathic & Osteopathic Physicians / Sleep Medicine. Allopathic & Osteopathic Physicians / Neurology is his primary health care specialty. Wilson, John R can be contacted via phone (630) 678-9240.

Contact Information

Primary practice address
1S443 Summit Ave Suite# 203 Oakbrook Terrace IL 60181-3989
Phone: (630) 678-9240
Fax: (630) 678-9243
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 036088430 Illinois
Allopathic & Osteopathic Physicians / Clinical Neurophysiology 2084N0600X 036088430 Illinois
Allopathic & Osteopathic Physicians / Sleep Medicine 2084S0012X 036088430 Illinois

Profile Details

NPI number 1548243678
LBN Legal business name Wilson, John R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 22nd, 2005
Last updated Apr 11th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548243678 NPPES
Illinois Other 1635130 BCBS
Illinois MEDICAID 036088430 BCBS

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