Gerald Wilson

NPI #1063100303 in Chicago, Illinois

Provider Information

NPI Number: 1063100303
Entity Type: Individual
Name: Gerald Wilson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Technician, Other
Enumeration Date: Apr 25, 2023
Last Updated: Apr 25, 2023

Practice Location

Address: 1004 N CLARK ST
City: Chicago
State: Illinois
ZIP Code: 60610-2941
Phone: (312) 291-9435

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician, Other	247200000X	Primary

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