MR. RANDALL LANE WILCOXEN PAC
NPI 1851363022
Physician Assistant in Peoria, IL

Active since February 02, 2006
5114 N GLEN PARK PLACE RD, PEORIA, IL 61614(309) 683-2402(309) 683-2419 Get Directions Write a Review

NPPES record last updated: January 23, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mr. Randall Lane Wilcoxen Pac NPPES

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

MR. RANDALL LANE WILCOXEN PAC (NPI 1851363022) is an individual physician assistant in Peoria, Illinois, licensed in Illinois (085000632) and active in the NPI registry since February 2006.

NPPES Registry Identity

NPI1851363022
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. RANDALL LANE WILCOXENCredential: PAC
Location Address5114 N GLEN PARK PLACE RDPeoria, IL 61614-4686
Mailing Address5114 N Glen Park Place RdPeoria, IL 61614-4686
Fax(309) 683-2419
Sole ProprietorNo
Enumeration DateFebruary 2, 2006
Last NPPES UpdateJanuary 23, 2015
NPI 1851363022 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in IL · 085000632
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

5114 N GLEN PARK PLACE RD, Peoria, IL 61614

Other Identifiers 1

Medicare ID-Type Unspecified205465IL

Other Providers at the Same Location NPPES 20

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

Social Worker (Clinical)
5114 N GLEN PARK PLACE RD
PEORIA, IL 61614
Physician Assistant
5114 N GLEN PARK PLACE RD
PEORIA, IL 61614
Nurse Practitioner
5114 N GLEN PARK PLACE RD
PEORIA, IL 61614
Nurse Practitioner
5114 N GLEN PARK PLACE RD
PEORIA, IL 61614
Nurse Practitioner
5114 N GLEN PARK PLACE RD
PEORIA, IL 61614
Nurse Practitioner (Family)
5114 N GLEN PARK PLACE RD
PEORIA, IL 61614
Physician Assistant (Medical)
5114 N GLEN PARK PLACE RD
PEORIA, IL 61614
Family Medicine
5114 N GLEN PARK PLACE RD
PEORIA, IL 61614

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 Randall Wilcoxen's NPI number?

The NPI number for Randall Wilcoxen is 1851363022. It was assigned to this individual provider in the NPPES registry on February 2, 2006.

Where is Randall Wilcoxen located?

Randall Wilcoxen practices at 5114 N Glen Park Place Rd, Peoria, IL 61614. The listed phone number is (309) 683-2402.

What is Randall Wilcoxen's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Randall Wilcoxen was last updated on January 23, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.