Provider Demographics
NPI:1821152067
Name:WILKERSON, RASHAD CLIFTON (DO)
Entity type:Individual
Prefix:DR
First Name:RASHAD
Middle Name:CLIFTON
Last Name:WILKERSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 W PARK
Mailing Address - Street 2:FAPC
Mailing Address - City:URBANA
Mailing Address - State:IL
Mailing Address - Zip Code:61802
Mailing Address - Country:US
Mailing Address - Phone:217-902-6954
Mailing Address - Fax:217-902-7711
Practice Address - Street 1:611 W PARK
Practice Address - Street 2:FAPC
Practice Address - City:URBANA
Practice Address - State:IL
Practice Address - Zip Code:61802
Practice Address - Country:US
Practice Address - Phone:217-902-6954
Practice Address - Fax:217-902-7711
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036169528207RG0100X
WI18229207RG0100X
VA0102201636207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology