NPI 1063100303

Gerald Wilson

Practitioner Other Technician Chicago, IL

Practice location

Address: 1004 N Clark St, Chicago, IL 60610-2941
Phone: (312) 291-9435

Registered specialties

Other Technician Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 247200000X Licence 011253222 (IL)

Other Technician, Other providers in Illinois →

Registry record

NPI: 1063100303
Entity type: Individual
Sex (as registered): Male
NPI issued: 25 Apr 2023
Record last updated: 25 Apr 2023

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.