Yvonne J Wilson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036114805 Issued in IL

Practice address

2535 E Washington St
East Peoria, IL 61611-1863

Phone

(309) 694-6464

Fax

(309) 694-6465

NPI assigned

Jun 20, 2006

Sex

Female

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 1

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.

• Comprehensive Emergency Solutions SC

  • Emergency Medicine Physician
  • Peoria, IL
  • NPI 1477515393
  NPD (past)

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279584000000",
    "number": "1568408698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 E WAR MEMORIAL DR",
            "city": "PEORIA HEIGHTS",
            "state": "IL",
            "postal_code": "616167757",
            "telephone_number": "309-685-0100",
            "fax_number": "309-685-0172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2535 E WASHINGTON ST",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616111863",
            "telephone_number": "309-694-6464",
            "fax_number": "309-694-6465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "YVONNE",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2010-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036114805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036114805",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Lynne Whetstone
• Sarah White, PHARMD
• Daniel Wilder, CPHT
• Jennifer Marian Wiles, M.S.
• Karrie Williamson
• Lauren Wiseman, APRN
• Krystyna Wojtkowski
• Andrea Nadine Worstell
• Carol Ruch Wylie, C.C.C./SLP
• Mary Kathleen Yoder, APRN, CNP

• Family Medicine Physician in East Peoria, IL
• Providers in East Peoria, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 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.