Tyiesha Wilson

Primary specialty

Clinical Laboratory Director (Non-physician)Taxonomy code 247ZC0005X

Practice address

2800 W Lake St
Chicago, IL 60612-1908

Phone

(773) 999-6071

NPI assigned

Dec 28, 2021

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Ace Clinical Experts LLC

  • Health Service Clinic/Center
  • Chicago, IL
  • NPI 1326708694
  NPD Authorized official

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

{
    "created_epoch": "1640649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1891455168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 W TAYLOR ST # 1105",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606074623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 W LAKE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606121908",
            "telephone_number": "773-999-6071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "TYIESHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-28",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247ZC0005X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Clinical Laboratory Director, Non-physician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanner Joseph Wilson, DC
• Tee Gee Wilson, M.D.
• Tony D Wilson, LCSW
• Toya Wilson, D.D
• Trover Gray Wilson, MSW/LCSW/CADC/CODP
• Tyler Wayne Wilson
• Uduakobong Wilson
• William B Wilson Jr., DDS
• Xavier Wilson
• Yvette T Wilson, NURSE PRACTITIONER

• Clinical Laboratory Director (Non-physician) in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Laboratory Director (Non-physician) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; 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.