SearchIllinois104100000X

Jasmine Wilson

NPI 1659298388 · on the registry since 2026

Practice

Address
11043 S Wallace St
Chicago, IL 60628
Phone
(773) 263-3099

Registry record

Primary taxonomy
104100000X
104100000X
Also registered as
1041S0200X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2026-07-02

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois