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Ethan Wilson
Student in an Organized Health Care Education/Training Program in Berwyn, Illinois
NPI 1285334276

Ethan Wilson is a Student in an Organized Health Care Education/Training Program based in Berwyn, IL. Ethan Wilson practices in Berwyn, IL. The NPI Number for Ethan Wilson is 1285334276 and holds a License No. (Illinois).

The current practice location address for Ethan Wilson is 3249 Oak Park Ave, Berwyn, IL and can be reached out via phone at 708-783-9100.

Location: 3249 Oak Park Ave, Berwyn, IL, 60402-3429
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1285334276
Provider Name
Ethan Wilson
Credential
Provider Entity Type
Individual
Gender
Male
Address
3249 Oak Park Ave, Berwyn, IL, 60402-3429
Phone Number
708-783-9100
Fax Number
Provider Enumeration Date
03/08/2023
Last Update Date
04/14/2024
institution
Provider Business Practice Location Address Details
Address
3249 Oak Park Ave
City
Berwyn
State
Illinois
Zip
60402-3429
Phone Number
708-783-9100
Fax Number
person
Provider Business Mailing Address Details
Address
3249 Oak Park Ave
City
Berwyn
State
Illinois
Zip
60402-3429
Phone Number
708-783-9100
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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