Dr Richard A Wilson, DO | |
15300 West Ave, Suite 20, Orland Park, IL 60462-4600 | |
(708) 460-5550 | |
(708) 226-2595 |
Full Name | Dr Richard A Wilson |
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Gender | Male |
Speciality | Emergency Medicine |
Location | 15300 West Ave, Orland Park, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1508867144 | NPI | - | NPPES |
036065125 | Medicaid | IL | |
F400265424 | Other | IL | MEDICARE PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | 036065125 (Illinois) | Primary |
Entity Name | Emergency Medical Associates Of Palos, Ltd. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1285918128 PECOS PAC ID: 1052578366 Enrollment ID: O20120127000880 |
Mailing Address | Practice Location Address |
---|---|
Dr Richard A Wilson, DO 12251 S 80th Ave, Suite 1630, Palos Heights, IL 60463-1256 Ph: (708) 923-5173 | Dr Richard A Wilson, DO 15300 West Ave, Suite 20, Orland Park, IL 60462-4600 Ph: (708) 460-5550 |
Mohammad Baig, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 16955 Blue Heron Dr, Orland Park, IL 60467 Phone: 708-229-9500 | |
Dr. John Leo Giovinco, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 16700 Muirfield Dr, Orland Park, IL 60467 Phone: 708-349-4757 | |
Cathleen M Mcgovern, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 15417 Sunset Ridge Dr, Orland Park, IL 60462 Phone: 708-873-1523 | |
Thierry J Dubois, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 15300 West Ave, Orland Park, IL 60462 Phone: 708-460-5550 Fax: 708-226-2595 |