Provider Demographics
NPI:1548307218
Name:WILKINS, JOANNE JEANETTE (OTR)
Entity type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:JEANETTE
Last Name:WILKINS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:563 TEWKSBURY CIR
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:IL
Mailing Address - Zip Code:60543-8715
Mailing Address - Country:US
Mailing Address - Phone:630-554-6445
Mailing Address - Fax:
Practice Address - Street 1:563 TEWKSBURY CIR
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:IL
Practice Address - Zip Code:60543-8715
Practice Address - Country:US
Practice Address - Phone:630-554-6445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist