MEDICARE: ANDREW ROBERT WILMINGTON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	036.164165	IL
2	207RH0003X	Hematology & Oncology Physician	036.164165	IL
3	208M00000X	Hospitalist Physician	036164165	IL

General Provider Information

NPI Number	:	1891255840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW ROBERT WILMINGTON MD

Provider Business Mailing Address
First Line	:	1725 W HARRISON ST STE 970
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-3828
Country	:	US
Telephone Number	:	312-942-8174
Fax Number	:

Provider Business Practice Location Address
First Line	:	1725 W HARRISON ST STE 970
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-3828
Country	:	US
Telephone Number	:	131-294-2500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2019
Last Update Date	:	06/09/2026

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