MEDICARE: MEGAN ERIKA WILSON DNP

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	363L00000X	Nurse Practitioner	209.026180	IL
2	363LF0000X	Family Nurse Practitioner	209.026180	IL

General Provider Information

NPI Number	:	1215648514
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN ERIKA WILSON DNP

Provider Business Mailing Address
First Line	:	1335 W ALTGELD ST APT 1B
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-2168
Country	:	US
Telephone Number	:	239-537-5049
Fax Number	:

Provider Business Practice Location Address
First Line	:	3301 N ASHLAND AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-2127
Country	:	US
Telephone Number	:	312-429-5725
Fax Number	:

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

Provider Enumeration Date	:	12/07/2022
Last Update Date	:	05/14/2025

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