Wilson, Jennifer Mary

Wilson, Jennifer Mary is an sole proprietor health care provider with primary practice located at 5702 Elaine Dr Suite A, Rockford IL 61108-2458. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Wilson, Jennifer Mary can be contacted via phone (815) 601-3981.

Contact Information

Primary practice address
5702 Elaine Dr Suite A Rockford IL 61108-2458
Phone: (815) 601-3981
Fax: (815) 399-1959
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 71007181 Illinois

Profile Details

NPI number 1114076460
LBN Legal business name Wilson, Jennifer Mary
Credentials PSYD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 9th, 2007
Last updated Oct 8th, 2015 - about 10 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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