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

Mrs. Lucy Nelson Wisdom, MD

Individual provider Dermatology Physician · NPI 1669510400

Mrs. Lucy Nelson Wisdom, MD is a Dermatology in Bloomington, Illinois. Graduated from Southern Illinois University School of Medicine in 2000, 26 years ago. Practices with Associates in Dermatology SC, a 6-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
26
Trained at
Southern Illinois University School of Medicine
Licensed in
IL
In the registry since
2007
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1404 Eastland Dr Ste 204
Bloomington, IL 61701
Phone: (309) 662-8813
Fax: (309) 662-6835
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 036110740 (IL)

Record details

NPI number1669510400
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedFebruary 2, 2007
Last updated in NPPESJuly 8, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Medical schoolSOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Graduated 2000 (26 years in practice)
Group practice Associates In Dermatology Sc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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