JACQUELINE ELLEN WILSON (NPI# 1972717205) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972717205 |
| Entity Type | Individual |
| Full Name | JACQUELINE ELLEN WILSON |
| Credential | MAQMHP |
| Practice Address |
988 N Illinois Route 3 Waterloo IL 62298-1000 |
| Mailing Address |
17 W Waters Edge Dr Belleville IL 62221-7801 |
| Practice Telephone | 6189394444 |
| Mailing Telephone | 6187897385 |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225687791 | Jacqueline Latia Wilson | Nurse Practitioner | 225 N Clifton Ave, Louisville, KY 40206-2496 | 2019-09-08 |
| 1790186393 | Jacqueline Wilson | Nurse Practitioner | 1101 Highway 76 Ste A, Clarksville, TN 37043-2420 | 2014-09-15 |
| 1295022622 | Jacqueline A. Wilson | Contractor | 12257 Middlebrook Sq, San Diego, CA 92128-3759 | 2011-07-06 |
| 1225244692 | Jacqueline Golden Wilson | Occupational Therapist | 15115 Eastview Dr, Upperco, MD 21155-9746 | 2007-05-15 |
| 1942373212 | Jacqueline Wilson | Counselor | 6 Cabot Pl Ste 6, Stoughton, MA 02072-4625 | 2006-11-16 |
| 1154951556 | Jacqueline Anne Wilson | Nurse Practitioner | 640 S 19th St Ste 100, Nevada, IA 50201-2902 | 2020-01-24 |
| 1457909830 | Jacqueline Lois Reagor Wilson | Speech-Language Pathologist | 9285 Medical Plaza Dr, Charleston, SC 29406-9126 | 2019-08-29 |
| 1245735943 | Jacqueline Wilson | Nurse Practitioner | 284 Highway 641 N, Camden, TN 38320-1350 | 2018-03-26 |
| 1457852014 | Jacqueline Wilson | Social Worker | 2219 Claiborne Ave, Shreveport, LA 71103-4301 | 2018-02-27 |
| 1801348636 | Jacqueline Sue Wilson | Physical Therapist | 901 N Porter Ave, Norman, OK 73071-6404 | 2016-10-27 |
| Street Address |
988 N ILLINOIS ROUTE 3 |
| City | WATERLOO |
| State | IL |
| Zip Code | 62298-1000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427059476 | Melissa I. Harris | Counselor | 988 N Illinois Route 3, Waterloo, IL 62298-1000 | 2005-08-02 |
| 1104425826 | Lindsey Maag | Rehabilitation Practitioner | 988 N Illinois Route 3, Waterloo, IL 62298-1059 | 2020-10-23 |
| 1124638564 | Anneleyce Dunlop | Case Manager/Care Coordinator | 988 N Illinois Route 3, Waterloo, IL 62298-1059 | 2020-07-31 |
| 1609404367 | Emma Schmidt | Case Manager/Care Coordinator | 988 N Illinois Route 3, Waterloo, IL 62298-1059 | 2020-03-30 |
| 1245868900 | Kizzy Partee | Rehabilitation Practitioner | 988 N Illinois Route 3, Waterloo, IL 62298-1059 | 2020-03-30 |
| 1245863612 | Daniel Valleroy | Case Manager/Care Coordinator | 988 N Illinois Route 3, Waterloo, IL 62298-1059 | 2020-02-13 |
| 1982237350 | Thea Palermo | Case Manager/Care Coordinator | 988 N Illinois Route 3, Waterloo, IL 62298-1059 | 2020-02-13 |
| 1255963997 | Kristen Harris | Rehabilitation Practitioner | 988 N Illinois Route 3, Waterloo, IL 62298-1059 | 2020-02-11 |
| 1013549765 | Amanda Sehr | Rehabilitation Practitioner | 988 N Illinois Route 3, Waterloo, IL 62298-1059 | 2020-02-11 |
| 1467084111 | Trisha Talamantes | Rehabilitation Practitioner | 988 N Illinois Route 3, Waterloo, IL 62298-1059 | 2020-02-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508471418 | Waterloo Urgent Care Walk In Clinic Company | Clinic/Center | 901 Illinois Route 3, Waterloo, IL 62298 | 2020-09-09 |
| 1235624867 | Las Davis Enterprises | Hearing Instrument Specialist | 911 State Rte 3, Waterloo, IL 62298 | 2018-06-26 |
| 1255727269 | Anna Witges | Counselor | 988 Il-3, Waterloo, IL 62298 | 2015-04-07 |
| 1558766741 | Sheri Buettner | Counselor | 988 Illinois Route 3, Waterloo, IL 62298 | 2014-10-30 |
| 1386050953 | Jessica Liefer | Counselor | 988 N Illinois Rt 3, Waterloo, IL 62298 | 2014-07-03 |
| 1952729279 | Orthodontic Associates of Columbia and Waterloo | Dentist | 224 Bradford Lane Suite B, Waterloo, IL 62298 | 2014-04-03 |
| 1588963961 | Monroe County Surgical Center,llc | Clinic/Center | 501 Hamacher St, Waterloo, IL 62298 | 2011-03-24 |
| 1841523776 | Waterloo Women's Health | Nurse Practitioner | 869 N. Illinois Rt 3, Waterloo, IL 62298 | 2009-09-10 |
| 1548444011 | Marla Rae Smith | Nurse Practitioner | 869 North Illinois Rt 3, Waterloo, IL 62298 | 2007-12-20 |
| 1649464553 | Clarkson Optometry Illinois PC | Optometrist | 204 Bradford Lane, Waterloo, IL 62298 | 2007-09-04 |
| Find all providers in zip 62298 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801447982 | Human Support Services | Counselor | 228 Bradford Ln Ste 2, Waterloo, IL 62298-3270 | 2019-09-20 |
| 1306363841 | Kristie Wood | Counselor | 1420 W. Donald St, Waterloo, IA 50703 | 2017-08-25 |
| 1316462682 | Samarah Greeves | Counselor | 3261 University Ave, Waterloo, IA 50701-2051 | 2017-08-08 |
| 1255727269 | Anna Witges | Counselor | 988 Il-3, Waterloo, IL 62298 | 2015-04-07 |
| 1558766741 | Sheri Buettner | Counselor | 988 Illinois Route 3, Waterloo, IL 62298 | 2014-10-30 |
| 1386050953 | Jessica Liefer | Counselor | 988 N Illinois Rt 3, Waterloo, IL 62298 | 2014-07-03 |
| 1427487537 | Tania Doverspike | Counselor | 3 Thurber Dr, Waterloo, NY 13165-9454 | 2013-11-08 |
| 1851728570 | Human Support Services | Counselor | 228 Bradford Ln, Apartment 5, Waterloo, IL 62298-3270 | 2013-09-27 |
| 1437586112 | Human Support Services | Counselor | 224 N Main St Rear, Waterloo, IL 62298-1264 | 2013-09-26 |
| 1770838997 | Lezli Mantzaris | Counselor | 1314 S 258th St, Waterloo, NE 68069-4814 | 2012-07-14 |
| Find all providers in WATERLOO | ||||
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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.