| Ms Jacqueline Wilson, | |
|
820 S Damen Ave, Chicago, IL 60612-3728 | |
| (312) 569-8387 | |
| Not Available |
| Full Name | Ms Jacqueline Wilson |
|---|---|
| Gender | Female |
| Speciality | Licensed Practical Nurse |
| Location | 820 S Damen Ave, Chicago, Illinois |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588825178 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | 043078127 (Illinois) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Jacqueline Wilson, 820 S Damen Ave, Chicago, IL 60612-3728 Ph: (312) 569-8387 | Ms Jacqueline Wilson, 820 S Damen Ave, Chicago, IL 60612-3728 Ph: (312) 569-8387 |
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