Wilson, Jennifer M

Wilson, Jennifer M is an individual health care provider with primary practice located at 1009 N Cummings Ln , Washington IL 61571-9646. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Wilson, Jennifer M can be contacted via phone (309) 670-2020.

Contact Information

Primary practice address
1009 N Cummings Ln Washington IL 61571-9646
Phone: (309) 670-2020
Fax: (309) 444-7863
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 046010759 Illinois

Profile Details

NPI number 1942551619
LBN Legal business name Wilson, Jennifer M
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 21st, 2012
Last updated Aug 24th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942551619 NPPES
Illinois Other 046010759 STATE LICENSE

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