Wilson, Matthew Todd

Wilson, Matthew Todd is an sole proprietor health care provider with primary practice located at 530 Ne Glen Oak Ave , Peoria IL 61637-0001. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as his primary health care specialty. Wilson, Matthew Todd can be contacted via phone (309) 655-2000.

Contact Information

Primary practice address
530 Ne Glen Oak Ave Peoria IL 61637-0001
Phone: (309) 655-2000
Fax: (309) 655-7869
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 364SA2200X 209.008422 Illinois

Profile Details

NPI number 1295045425
LBN Legal business name Wilson, Matthew Todd
Credentials ACNS-BC, APN
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 21st, 2010
Last updated Oct 21st, 2010 - about 14 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.

Request for update

Popular Providers