| Dr David B Wilson, MD | |
|
1000 Corporate Grove Dr, Buffalo Grove, IL 60089-4550 | |
| (224) 588-9940 | |
| (224) 588-9941 |
| Full Name | Dr David B Wilson |
|---|---|
| Gender | Male |
| Speciality | Pathology - Anatomic Pathology & Clinical Pathology |
| Location | 1000 Corporate Grove Dr, Buffalo Grove, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548247422 | NPI | - | NPPES |
| 000000191567 | Other | IN | ANTHEM |
| 000000014566 | Other | IN | MPLAN |
| 200329070A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207ZH0000X | Pathology - Hematology | 01049186A (Indiana) | Secondary |
| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 01049186A (Indiana) | Primary |
| Entity Name | Gopath Pathology Associates, Sc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700152311 PECOS PAC ID: 4688830151 Enrollment ID: O20120727000389 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr David B Wilson, MD 1359 Barclay Blvd, Buffalo Grove, IL 60089-4501 Ph: (224) 588-9940 | Dr David B Wilson, MD 1000 Corporate Grove Dr, Buffalo Grove, IL 60089-4550 Ph: (224) 588-9940 |
Dr. Jim Zb Lu, MD Pathology Medicare: May Accept Medicare Assignments Practice Location: 1000 Corporate Grove Dr, Buffalo Grove, IL 60089 Phone: 224-588-9940 Fax: 224-588-9941 | |
Shiwen Song, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 1351 Barclay Blvd, Buffalo Grove, IL 60089 Phone: 224-588-9940 Fax: 224-588-9941 | |
Dr. Yousef Ebeid Tadros, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 1351 Barclay Blvd, Buffalo Grove, IL 60089 Phone: 224-588-9940 Fax: 224-588-9941 |