IndividualActive
Amanda Wilderman
NPI 1659915171 · Adult Medicine Physician · Carbondale, IL
Provider details
- NPI number
- 1659915171
- Entity type
- Individual
- Primary specialty
- Adult Medicine PhysicianAllopathic & Osteopathic Physicians
- Sex
- Female
- Sole proprietor
- Yes
- License
- 209.020318 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1100 W Diann Ln
Carbondale, IL 62901-5339
Phone: (618) 549-8006
Fax: (618) 549-8434
Approximate (ZIP-level) locationGet directions
Mailing address
1268 Cole Place Rd
Chester, IL 62233-2054
Additional practice locations (1)
- 1309 Allendale BlvdChester, IL 62233-1319Phone: (618) 497-4264
Registry dates
- Enumerated
- 2019-10-29
- Last updated
- 2023-03-24
- Certified
- 2023-03-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.