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General NPI Number Information
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NPI Number | 1821152067
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Entity Type | Individual
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Provider Name | RASHAD CLIFTON WILKERSON D.O.
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Gender | Male
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 611 W PARK FAPC
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City | URBANA
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State | IL
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Zip | 61802
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Country | US
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Telephone | 217-902-6954
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Fax | 217-902-7711
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Provider Business Mailing Address
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Address Line | 611 W PARK FAPC
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City | URBANA
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State | IL
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Zip | 61802
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Country | US
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Telephone | 217-902-6954
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Fax | 217-902-7711
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 036169528
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 18229
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 0102201636
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License Number State | VA
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