MEDICARE: KATHARINE WILCOX MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	036164460	IL

General Provider Information

NPI Number	:	1184244089
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHARINE WILCOX MD

Provider Business Mailing Address
First Line	:	1919 W TAYLOR ST RM 175
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-7246
Country	:	US
Telephone Number	:	312-355-1706
Fax Number	:	312-996-2579

Provider Business Practice Location Address
First Line	:	1740 WEST TAYLOR STREET
Second Line	:	UNIVERSITY OF ILLINOIS HOSPITAL
City	:	CHICAGO
State	:	IL
Zip	:	60612-7236
Country	:	US
Telephone Number	:	866-600-2273
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/21/2020
Last Update Date	:	05/14/2025

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