Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
AMANDA S WILSON, ATC
ActiveSports Medicine (EM) · LA GRANGE HIGHLANDS, IL
Registration Details
- NPI Number
- 1548238066
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Mar 10, 2006 (20.118222312834 yrs)
- Last Updated
- Jul 8, 2007
Practice Information
- Address
-
5544 WILLOW SPRINGS RDLA GRANGE HIGHLANDS, IL, 605253474Browse IL providers · Browse ZIP 60525
- Phone
- 7082051961
- Primary Specialty
-
Sports Medicine (EM)
207PS0010X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.