Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Randall Lane Wilcoxen, PAC

Individual provider Physician Assistant · NPI 1851363022

Mr. Randall Lane Wilcoxen, PAC is a Physician Assistant in Peoria, Illinois. Licensed in Illinois. Registered with an NPI since 2006.

Licensed in
IL
In the registry since
2006
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

5114 N Glen Park Place Rd
Peoria, IL 61614-4686
Phone: (309) 683-2402
Fax: (309) 683-2419
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085000632 (IL)

Record details

NPI number1851363022
Entity typeIndividual (Type 1)
GenderMale
Credentials PAC
Sole proprietorNo
NPI enumeratedFebruary 2, 2006
Last updated in NPPESJanuary 23, 2015

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