1861427098 NPI number — JAMES A WILCOX PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861427098 NPI number — JAMES A WILCOX PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JAMES A WILCOX PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861427098
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/31/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 382
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BARRINGTON
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60011-0382
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-382-6579
Provider Business Mailing Address Fax Number:
847-382-7194

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
120 N NORTHWEST HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BARRINGTON
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60010-3347
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-382-6579
Provider Business Practice Location Address Fax Number:
847-382-7194
Provider Enumeration Date:
07/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WILCOX
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
A
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
847-382-6579

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  036109429 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 04932483 . This is a "BCBS" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




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