RANDALL E WILSON


Address: 4121 Old Collinsville Rd, Swansea, IL 62226-2511
Phone: 6182360501

RANDALL E WILSON (NPI# 1891316535) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1891316535
Entity Type Organization
Organization Name RANDALL E WILSON
Practice Address 4121 Old Collinsville Rd
Swansea
IL 62226-2511
Practice Telephone 6182360501
Mailing Telephone 6182360501
Enumeration Date 2020-05-05
Last Update Date 2020-05-05
Authorized Official Name DR. RANDALL E WILSON (OWNER)
Authorized Official Telephone 6182360501
Authorized Official Credential DDS
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QD0000X Clinic/Center
Specialization: Dental
Ambulatory Health Care Facilities

Office Location

Street Address 4121 OLD COLLINSVILLE RD
City SWANSEA
State IL
Zip Code 62226-2511

Providers in the same location

NPI Name Taxonomy Address Enumeration
1467438374 Jeffrey Charles Banker Dentist 4121 Old Collinsville Rd, Swansea, IL 62226-2441 2005-12-22
1730700477 Lauren Brittany Wilson Dentist 4121 Old Collinsville Rd, Swansea, IL 62226-2511 2020-05-05
1164540365 Randall Eugene Wilson Dentist 4121 Old Collinsville Rd, Swansea, IL 62226-2441 2007-03-26

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1639778160 Roxanna Lee Gunnels Nurse Practitioner 1 Bronze Pointe Plaza Suite 1a, Swansea, IL 62226 2020-10-26
1053969790 Consistent Medical Transportation Driver 2012 N 17th St, Swansea, IL 62226 2019-08-27
1497314371 Medi-plex Hospice of Illinois, LLC Registered Nurse 8 Park Place, Suite #3, Swansea, IL 62226 2019-06-13
1336617364 Nicole Renee Schmidt Speech-Language Pathologist 150 N 27th St., Belleville, IL 62226 2018-11-07
1295258903 Catherine Espino Pharmacist 11 Chambers Blvd, Swansea, IL 62226 2017-07-25
1366806838 Kiley Faires Nurse Practitioner 4600 Memorial Drive Ste 360, Belleville, IL 62226 2016-04-11
1760857585 Mvp Transportation Non-emergency Medical Transport (VAN) 1229 N 17th Street, Number 23, Belleville, IL 62226 2015-12-04
1275952566 Aisha Danyale Franklin Internal Medicine 4261 Woodfield Pl, Belleville, IL 62226 2014-04-15
1396168332 Jayne E. Ninness Physical Therapy Assistant 4500 Memorial Dr., Memorial Hospital, Belleville, IL 62226 2014-01-28
1053758193 Gateway Foundation, Inc. Clinic/Center 1 Bronze Point, Suite 1, Swansea, IL 62226 2013-05-30
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Taxonomy Information

Taxonomy Code 261QD0000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Dental

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1669953618 Ashley Gomes-moore, Dmd Pllc Clinic/Center 755 Gar Hwy, Swansea, MA 02777-4504 2018-08-28
1518418227 Symmetry Dental & Spa Inc Clinic/Center 1719 Gar Hwy, Swansea, MA 02777-3940 2016-10-18
1821458936 Swansea Dental Associates, PC Clinic/Center 225 Wilbur Ave, Swansea, MA 02777-2620 2016-03-02
1932428026 Lepine Dentistry, LLC. Clinic/Center 1010 Gar Hwy, Swansea, MA 02777-4566 2010-05-27

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1124629514 Chicago Pediatric Dentistry and Orthodontics Clinic/Center 1136 S Delano Ct W Ste B202, Chicago, IL 60605-3734 2020-11-03
1437750031 Secure Dental Xi Clinic/Center 1843 W Golf Rd, Schaumburg, IL 60194-1148 2020-11-02
1780283267 Jenna Gaw, Dds, Pllc Clinic/Center 1724 Locust Pl Apt 303, Schaumburg, IL 60173-4239 2020-10-26
1740889344 Nsp Dental LLC Clinic/Center 1900 Hollister Dr Ste 190, Libertyville, IL 60048-5283 2020-10-23
1285232827 Paul Doodes Dds Phd PC Clinic/Center 45 S Park Blvd Ste 190, Glen Ellyn, IL 60137-6282 2020-10-15
1780290676 Great Smile Dental Pllc Clinic/Center 720 Osterman Ave Ste 304, Deerfield, IL 60015-4339 2020-09-16
1669087375 Naperville Smiles Dental Clinic/Center 8 W Gartner Rd Ste 124, Naperville, IL 60540-7549 2020-09-09
1649883364 Mark J Maly Estate Clinic/Center 103 S Main St # Po, Orangeville, IL 61060-9244 2020-08-24
1760094718 Stoffel and Tomazin Dental Associates, Ltd Clinic/Center 5718 W 35th St, Cicero, IL 60804-4222 2020-08-20
1215548771 Meda Dental II LLC Clinic/Center 2735 Hassert Blvd Ste 159, Naperville, IL 60564-5205 2020-08-10
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Competitor

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City SWANSEA
Zip Code 62226

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Dataset Information

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.

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