Ms Tiffany Andrae Wilson, is a
Social Worker - Clinical based in Crystal Lake, Illinois. Ms Tiffany Andrae Wilson is licensed to practice in * (Not Available) (license number ) and her current practice location is
145 S Virginia St, Crystal Lake, Illinois. She can be reached at her office (for appointments etc.) via phone at
(815) 527-7300.
NPI number for Ms Tiffany Andrae Wilson is 1992359046 and her current mailing address is 5924 Clarendon Dr, Rockford, Illinois. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1992359046.
Healthcare Provider's Profile
Full Name | Ms Tiffany Andrae Wilson |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 145 S Virginia St, Crystal Lake, Illinois |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1992359046
- Provider Enumeration Date: 07/27/2019
- Last Update Date: 09/24/2020
Medical Identifiers
Medical identifiers for Ms Tiffany Andrae Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1992359046 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Tiffany Andrae Wilson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Ms Tiffany Andrae Wilson, 5924 Clarendon Dr, Rockford, IL 61114-5510 Ph: (779) 207-6699 | Ms Tiffany Andrae Wilson, 145 S Virginia St, Crystal Lake, IL 60014-7226 Ph: (815) 527-7300 |
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