| Doctor Name: | JALINE WILKES |
| NPI Number: | 1093175101 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | COA.18835-NP |
| Business Practice Address: | 13944 Euclid Ave East Cleveland, OH - 441123804 |
| Business Phone Number: | 2167674292 |
| Business Fax Number: | 2167674274 |
| Mailing Address: | 13944 Euclid Ave, EAST CLEVELAND |
| State: | OH |
| Postal Code: | 441123804 |
| Phone Number: | 2167674292 |
| Fax Number: | 2167674274 |
| NPI Enumeration Date: | 03/02/2016 |
| NPI Last Update Date: | 03/02/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | COA.18835-NP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |