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1144279100
SUSAN WILDE
MCHENRY, IL
NPI
1144279100
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0200X Nurse Practitioner, Pediatrics
(Licence: IL 041246908)
Enumeration Date
2006-05-08
Last Update Date
2007-08-31
Business Address
-- SUSAN WILDE CNP
4309 W MEDICAL CENTER DR B310
MCHENRY, IL 60050-8419
Phone number: 815-344-0900
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Mailing Address
-- SUSAN WILDE CNP
3707 DOTY RD SUITE G
WOODSTOCK, IL 60098-7530
Phone number: 815-206-1067
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