Active NPI
Buckey Lyn Wilson, MS, ATC
- Athletic Trainer
- North Chicago, IL
National Provider Identifier
1093783524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 1717 17TH St
North Chicago, IL 60064-2052 - Phone
- (847) 578-7400
- NPI assigned
- Mar 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | IL | Primary |
Addresses
Primary practice location
1717 17TH St
North Chicago, IL 60064-2052
Mailing address
795 N McKinley Rd
Lake Forest, IL 60045-1836
Phone (847) 370-0624
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 096-001405 | IL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1093783524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "795 N MCKINLEY RD",
"city": "LAKE FOREST",
"state": "IL",
"postal_code": "600451836",
"telephone_number": "847-370-0624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 17TH ST",
"city": "NORTH CHICAGO",
"state": "IL",
"postal_code": "600642052",
"telephone_number": "847-578-7400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "BUCKEY",
"middle_name": "LYN",
"name_prefix": "Mr.",
"credential": "MS, ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-10",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.