NPI 1003143967

Michael N Wilson

Practitioner Mental Health Counselor Chicago, IL

Practice location

Address: 1340 S Damen Ave, Chicago, IL 60608-1169
Phone: (312) 738-5926
Fax: (312) 666-6978

Registered specialties

Mental Health Counselor Primary

Behavioral Health & Social Service Providers Taxonomy 101YM0800X Licence 180.006114 (IL)

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Registry record

NPI: 1003143967
Entity type: Individual
Sex (as registered): Male
NPI issued: 12 Nov 2009
Record last updated: 12 Nov 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.