Healthcare Provider Details

I. General information

NPI: 1972874352
Provider Name (Legal Business Name): JENNIFER HARLIN WILHELM DVM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2012
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 COLUMBIA CENTER DRIVE BELLSON ANIMAL HOSPITAL
COLUMBIA IL
62236
US

IV. Provider business mailing address

1400 COLUMBIA CENTER DRIVE
COLUMBIA IL
62236
US

V. Phone/Fax

Practice location:
  • Phone: 618-281-5100
  • Fax:
Mailing address:
  • Phone: 618-281-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number090008503
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number2001025597
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: