Individual ProviderSquavette WilsonRegistered NurseNursing Service ProvidersPractice Address1015 W Lawrence Ave, Chicago, IL 60640-5017(773) 275-2586PECOS EnrollmentBased on the most recent information from CMS, provider Squavette Wilson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1760196612Provider TypeIndividualFull NameWilson, SquavetteCredentialRNGenderFemaleSole ProprietorNoEnumeration Date1/5/2023Last Updated1/5/2023Contact InformationPractice LocationPractice Address1015 W Lawrence Ave, Chicago, IL 60640-5017Phone(773) 275-2586FaxUnlisted FaxMailing LocationMailing Address1015 W Lawrence Ave, Chicago, IL 60640-5017PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicense041.372571Illinois