Healthcare Provider Details

I. General information

NPI: 1730187949
Provider Name (Legal Business Name): JAMES A WILCOX D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 10/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 N NORTHWEST HWY
BARRINGTON IL
60010-3347
US

IV. Provider business mailing address

120 N NORTHWEST HWY
BARRINGTON IL
60010-3347
US

V. Phone/Fax

Practice location:
  • Phone: 847-382-6579
  • Fax: 847-382-7194
Mailing address:
  • Phone: 847-382-6579
  • Fax: 847-382-7194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036109429
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: