Michael F. Wilson, M.D., LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

036-060142 Issued in IL

Legal business name

MICHAEL F. WILSON, M.D., LLC

Practice address

1427 S Evergreen Ave
Arlington Heights, IL 60005-3741

Phone

(847) 560-4676

Fax

(630) 689-5809

NPI assigned

Sep 18, 2007

Last updated

Mar 29, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael Fentriss Wilson, M.D.NPI 1083600027

Title

Owner

Phone

(847) 560-4676

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Fentriss Wilson, M.D.

  • Surgery Physician
  • Hoffman Estates, IL
  • NPI 1083600027
  Authorized official Same address or phone

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269820800000",
    "number": "1588850192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 E WING ST",
            "address_2": "#185",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600046064",
            "telephone_number": "847-560-4676",
            "fax_number": "630-689-5809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1427 S EVERGREEN AVE",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600053741",
            "telephone_number": "847-560-4676",
            "fax_number": "630-689-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL F. WILSON, M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-18",
        "last_updated": "2010-03-29",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "FENTRISS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-560-4676",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036-060142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MGB Services, Inc.
• Nazam Mian
• Carrie Marie Mianulli, DT
• Renamarie Miracle Miceli
• Michael Davison, PHD
• Michael J Louise, DC, LTD
• Raman Michael, MD
• Susan F. Michaelis, RPH
• Elizabeth Teloh Michalowicz, OTR/L
• Michelle R Michalski

• Surgery Physician in Arlington Heights, IL
• Providers in Arlington Heights, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.