Warren Matthew Wilkins, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

036-77270 Issued in IL

Practice address

450 Mayo Dr
Galesburg, IL 61401-1211

Phone

(309) 344-2831

Fax

(309) 344-2014

NPI assigned

Oct 11, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Western Illinois Cancer Treatment Center

  • Radiation Therapy Radiologic Technologist
  • Galesburg, IL
  • NPI 1417985011
  NPD (past) Authorized official
• Central Illinois Radiation Oncology Physicians, LTD

  • Radiation Oncology Physician
  • Peoria, IL
  • NPI 1003857061
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284595200000",
    "number": "1255429494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 MAYO DR",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614011211",
            "telephone_number": "309-344-2831",
            "fax_number": "309-344-2014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 MAYO DR",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614011211",
            "telephone_number": "309-344-2831",
            "fax_number": "309-344-2014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINS",
        "first_name": "WARREN",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2010-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036-77270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE INS.",
            "identifier": "014885",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "036077270",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CM5868",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300016168",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "920-000-334",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036077270",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Candace Lynn Whitman, LCPC
• Thomas J Whittle, M.D.
• Mark A Wiechert, M.D.
• Ronald J Wiechert, MD, PHD
• Rita Nichole Wilcox, DC
• Kaleena Williams
• Rachel Morgan Williams, APN
• Craig James Wilson, M.D.
• Jeffery James Wilson, DC
• Patricia M Wilson

• Specialist in Galesburg, IL
• Providers in Galesburg, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.