Healthcare Provider Details

I. General information

NPI: 1043766710
Provider Name (Legal Business Name): STEVEN WILCOX
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2016
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 AIRPORT RD STE C
ELGIN IL
60123-9329
US

IV. Provider business mailing address

295 GLENDALE LN
HOFFMAN ESTATES IL
60169-3205
US

V. Phone/Fax

Practice location:
  • Phone: 847-462-6099
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.025171
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: