Provider Demographics
NPI:1043021876
Name:WILKINSON, MADELYN ALICE
Entity type:Individual
Prefix:
First Name:MADELYN
Middle Name:ALICE
Last Name:WILKINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 MERGANSER CT
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60046-4932
Mailing Address - Country:US
Mailing Address - Phone:847-287-7160
Mailing Address - Fax:
Practice Address - Street 1:411 MERGANSER CT
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:IL
Practice Address - Zip Code:60046-4932
Practice Address - Country:US
Practice Address - Phone:847-287-7160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant