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Kevin Wilson, PA-C
Medical Physician Assistant in Belleville, Illinois
NPI 1063424984

Kevin Wilson is a Medical Physician Assistant based in Belleville, IL and is specialized in Medical. Kevin Wilson practices in Belleville, IL and has the professional credentials of PA-C. The NPI Number for Kevin Wilson is 1063424984 and holds a License No. 085-000488 (Illinois).

The current practice location address for Kevin Wilson is 130 Lincoln Place Ct, Belleville, IL and can be reached out via phone at 618-257-2029 and via fax at 618-235-5371. You can also correspond with Kevin Wilson through the mailing address at 4500 MEMORIAL DRIVE, BELLEVILLE, IL - 62226 (mailing address contact number: 618-257-4644).

Location: 130 Lincoln Place Ct, Belleville, IL, 62226
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Provider Profile Details
NPI Number
1063424984
Provider Name
Kevin Wilson
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
130 Lincoln Place Ct, Belleville, IL, 62226
Phone Number
618-257-2029
Fax Number
618-235-5371
Provider Enumeration Date
08/12/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
085-000488 01 IL STATE LICENSE
institution
Provider Business Practice Location Address Details
Address
130 Lincoln Place Ct
City
State
Zip
62221-5884
Phone Number
618-257-2029
Fax Number
618-235-5371
person
Provider Business Mailing Address Details
Address
130 Lincoln Place Ct
City
State
Zip
62221-5884
Phone Number
618-257-2029
Fax Number
618-235-5371
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
085-000488 (Illinois)
Definition
Definition to come...
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