Provider Demographics
NPI:1972652147
Name:WILCOX, JAMES MCDONALD (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MCDONALD
Last Name:WILCOX
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 MAPLE LN
Mailing Address - Street 2:
Mailing Address - City:SHOREWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60431-9743
Mailing Address - Country:US
Mailing Address - Phone:815-741-2498
Mailing Address - Fax:
Practice Address - Street 1:181 N HAMMES AVE
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-6675
Practice Address - Country:US
Practice Address - Phone:815-725-4269
Practice Address - Fax:815-725-9363
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry