AMANDA MARIE WILDERMAN (NPI# 1659915171) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659915171 |
| Entity Type | Individual |
| Full Name | AMANDA MARIE WILDERMAN |
| Practice Address |
1268 Cole Place Rd Chester IL 62233-2054 |
| Practice Telephone | 6182107478 |
| Mailing Telephone | 6182107478 |
| Enumeration Date | 2019-10-29 |
| Last Update Date | 2019-10-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
209.020318 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
1268 COLE PLACE RD |
| City | CHESTER |
| State | IL |
| Zip Code | 62233-2054 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164840740 | Malorie K Morris | Dentist | 9449 Mill Creek Road, Chester, IL 62233 | 2014-04-01 |
| 1366655268 | Adam Matthew Gibbs | Chiropractor | 423 W Holmes St, Chester, IL 62233 | 2007-05-07 |
| 1982816625 | Jodi Beth Buskohl Southern Il Chiropractic Clinic | Chiropractor | 2447 State St., Chester, IL 62233 | 2007-05-04 |
| 1881806008 | Human Service Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3298 Dawnview Road, Chester, IL 62233 | 2007-05-03 |
| 1356563563 | Human Service Center of Southern Metro East | Clinic/Center | 115 East Stacey Street, Chester, IL 62233 | 2007-05-03 |
| 1902951536 | Southern Illinois Eye Care, PC | Optometrist | 425 W. Holmes, Chester, IL 62233 | 2007-01-24 |
| 1235117417 | Chester Clinic Professional Corp | Clinic/Center | 2319 Old Plank Rd, Chester, IL 62233 | 2006-01-06 |
| 1881951648 | Sara Elizabeth Chandler | Nurse Practitioner | 1315 Lehmen Drive, Chester, IL 62233 | 2012-04-18 |
| 1245323260 | Eve B Hoover | Physician Assistant | 2319 Old Plank Rd, Chester Clinic PC, Chester, IL 62233 | 2006-10-02 |
| 1154387850 | Brett A Prywitch | Radiology | 1900 State St, Chester Memorial Hospital, Chester, IL 62233 | 2006-04-22 |
| Find all providers in zip 62233 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043811425 | Devon Homecare Physicians Inc. | Family Medicine | 2822 W. Granville Ave. Apt 1, Chicago, IL 60659 | 2020-11-03 |
| 1699277038 | Eileen A Solis | Family Medicine | 1795 Grandstand Pl Ste 2, Elgin, IL 60123-4980 | 2018-03-01 |
| 1841703584 | Home Physicians of Illinois LLC | Family Medicine | 10027 Frontage Rd, Skokie, IL 60077-1033 | 2017-11-15 |
| 1770953986 | Mrs Integrative Medicine LLC | Family Medicine | 3s630 Glen Dr S, Warrenville, IL 60555-3506 | 2015-09-30 |
| 1447666318 | M & F Medical Services, Ltd | Family Medicine | 5642 N Christiana Ave, Chicago, IL 60659-4555 | 2014-07-10 |
| 1457767774 | Rambha Radhakrishnan | Family Medicine | 2645 W Peterson Ave, Chicago, IL 60659-4017 | 2014-07-08 |
| 1851733133 | Pyramids Advisors, Inc. | Family Medicine | 6427 Dempster St, Morton Grove, IL 60053-2604 | 2013-07-26 |
| 1558707075 | Jean M. Pouget | Family Medicine | 175 Northgate Rd, Riverside, Riverside, IL 60546-1683 | 2013-05-13 |
| 1629411806 | Rahman Fazil Mohammed Abdul | Family Medicine | 9011 W Ballard Rd Apt 1a, Des Plaines, IL 60016-4987 | 2013-04-08 |
| 1730425851 | Fountain Healthcare Limited Liability Company | Family Medicine | 1639 N 1590th Rd, Streator, IL 61364-9644 | 2012-12-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.