Healthcare Provider Details

I. General information

NPI: 1659701704
Provider Name (Legal Business Name): MICHELE MARIE WILKINSON APRN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/26/2013
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 W MEDICAL CENTER DR
MCHENRY IL
60050-8409
US

IV. Provider business mailing address

1916 EASTMORELAND AVE
ROCKFORD IL
61108-6345
US

V. Phone/Fax

Practice location:
  • Phone: 815-759-4293
  • Fax: 815-759-8154
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number277.003099
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number277.003099
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number277.003099
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: