Kelsey Wild

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149024959 Issued in IL

Practice address

1560 Wall St Ste 204
Naperville, IL 60563-1146

Phone

(815) 541-5365

NPI assigned

Mar 31, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Richard Kneip, PH.D., P.C.

  • Community/Behavioral Health Agency
  • Clarkston, MI
  • NPI 1679739700
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1680220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1003511999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 COURTLAND ST",
            "city": "WARREN",
            "state": "IL",
            "postal_code": "610879335",
            "telephone_number": "815-541-5365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 WALL ST STE 204",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605631146",
            "telephone_number": "815-541-5365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILD",
        "first_name": "KELSEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-31",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149024959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Marie Wiese, M.D.
• Tiffany Nohelani Wiesner
• Catherine Wigder, MD
• Deanna Wiggin
• Wild Roots Occupational Therapy
• Jennifer Ann Wileman, P.T.
• Melanie M. Wilke, APN-CNP
• Christine Renae Wilkerson, D.C.
• Jessica Wilkiel, LPC
• Megan Elizabeth Wilkison, OTR/L

• Clinical Social Worker in Naperville, IL
• Providers in Naperville, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.