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General NPI Number Information
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NPI Number | 1083737654
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Entity Type | Individual
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Provider Name | JULIE R WILSON DC
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Gender | Female
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 820 N ORLEANS ST 345
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City | CHICAGO
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State | IL
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Zip | 60610-3132
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Country | US
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Telephone | 312-467-0678
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Fax |
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Provider Business Mailing Address
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Address Line | 110 N PEORIA ST 305
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City | CHICAGO
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State | IL
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Zip | 60607-2396
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Country | US
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Telephone | 847-977-8840
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State | IL
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