Thomas L Wilson M D LTD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

060001084 Issued in IL

Legal business name

THOMAS L WILSON M D LTD

Practice address

814 W State
Jacksonville, IL 62650

Phone

(217) 243-1865

Fax

(217) 243-6765

NPI assigned

Apr 12, 2006

Organization subpart

No

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

Authorized official

Name

Charles Stott Wilson, MD

Title

Physician

Phone

(217) 243-1865

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Margaret Ann Wilson, MD

  • Pediatrics Physician
  • Jacksonville, IL
  • NPI 1497761498
  NPD (past)

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306886400000",
    "number": "1275597817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 W STATE",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "62650",
            "telephone_number": "217-243-1865",
            "fax_number": "217-243-6765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 W STATE",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "62650",
            "telephone_number": "217-243-1865",
            "fax_number": "217-243-6765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS L WILSON M D LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-12",
        "last_updated": "2011-06-01",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "STOTT",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "217-243-1865",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": "IL",
            "license": "060001084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036043460",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie W Tennill, MSW, ACSW, LCSW
• William R Tennill, LCSW
• Testing Centers of America LLC
• The Grove Health and Rehab Center LLC
• The Grove Health and Rehab Center LLC
• Todd O Thorsen
• Erin Tighe, RBT
• Kirsten Timmons, N.P.
• David Charles Tonry, CRNA
• Jill M Trone, SPEECH/LANGUAGE PATH

• Urology Physician in Jacksonville, IL
• Providers in Jacksonville, IL by specialty
• Urology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2011; 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.