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KEVIN WILSON PA-C
NPI 1063424984
Physician Assistant - Medical in Belleville, IL

Active since August 12, 2006
130 LINCOLN PLACE CT, BELLEVILLE, IL 62221(618) 257-2029(618) 235-5371 Get Directions Write a Review

NPPES record last updated: March 21, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kevin Wilson Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEVIN WILSON PA-C (NPI 1063424984) is an individual medical provider in Belleville, Illinois, licensed in Illinois (085-000488) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1063424984
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameKEVIN WILSONCredential: PA-C
Location Address130 LINCOLN PLACE CTBelleville, IL 62221-5884
Mailing Address4500 Memorial Drive, Memorial Hospital Credentialing DepartmentBelleville, IL 62226 · (618) 257-4644 · Fax (618) 257-6946
Phone(618) 257-2029
Fax(618) 235-5371
Sole ProprietorNo
Enumeration DateAugust 12, 2006
Last NPPES UpdateMarch 21, 2016
✔ NPI 1063424984 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in IL · 085-000488
130 LINCOLN PLACE CT, Belleville, IL 62221
Open in Google Maps ↗

Other Identifiers 1

Other085-000488IL · State License

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PAMELA A O'NEAL NP
Nurse Practitioner
130 LINCOLN PLACE CT
BELLEVILLE, IL 62221
St. Clair County (618) 257-2029
STEPHEN GREGORY HIPSKIND MD, PHD
Internal Medicine (Geriatric Medicine)
130 LINCOLN PLACE CT
BELLEVILLE, IL 62221
St. Clair County (618) 257-2029
PC ASSOCIATES, LLC
Internal Medicine
130 LINCOLN PLACE CT
BELLEVILLE, IL 62221
St. Clair County (618) 257-1297
SUSAN KELLER APN,
Nurse Practitioner
130 LINCOLN PLACE CT
BELLEVILLE, IL 62221
St. Clair County (618) 257-2029

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kevin Wilson's NPI number?

The NPI number for Kevin Wilson is 1063424984. It was assigned to this individual provider in the NPPES registry on August 12, 2006.

Where is Kevin Wilson located?

Kevin Wilson practices at 130 Lincoln Place Ct, Belleville, IL 62221. The listed phone number is (618) 257-2029.

What is Kevin Wilson's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Kevin Wilson was last updated on March 21, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.