Wilson, Kevin

Wilson, Kevin is an individual health care provider with primary practice located at 130 Lincoln Place Ct , Belleville IL 62221-5884. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Wilson, Kevin can be contacted via phone (618) 257-2029.

Contact Information

Primary practice address
130 Lincoln Place Ct Belleville IL 62221-5884
Phone: (618) 257-2029
Fax: (618) 235-5371
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 085-000488 Illinois

Profile Details

NPI number 1063424984
LBN Legal business name Wilson, Kevin
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 12th, 2006
Last updated Mar 21st, 2016 - about 7 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 1063424984 NPPES
Illinois Other 085-000488 STATE LICENSE

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