Clare Tucker Wildes

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149009359 Issued in IL

Practice address

4250 N Marine Dr
Suite 236
Chicago, IL 60613-1744

Phone

(773) 404-0160

Fax

(773) 404-9876

NPI assigned

Oct 16, 2009

Last updated

Oct 19, 2009By the provider in NPPES

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

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The ThresholdsGroup PAC ID 6204826647, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• The Thresholds

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
  • NPI 1669488029
  Medicare reassignment Care Compare group
• The Thresholds

  dba Bridge Southeast

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
  • NPI 1831520261
  NPD

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

{
    "created_epoch": "1255651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255910400000",
    "number": "1093040594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4250 N MARINE DR",
            "address_2": "SUITE 236",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606131744",
            "telephone_number": "773-404-0160",
            "fax_number": "773-404-9876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 N MARINE DR",
            "address_2": "SUITE 236",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606131744",
            "telephone_number": "773-404-0160",
            "fax_number": "773-404-9876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDES",
        "first_name": "CLARE",
        "middle_name": "TUCKER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-16",
        "last_updated": "2009-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149009359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Joseph Wilda, SOCIAL WORK, MSW
• James Demaris Wilde, MA, LCPC
• Mark Wildeboer, PT, DPT, OCS
• Bart Anthony Wilder Jr., DO
• Mya Wilder
• Jennifer Wildes
• Wildflower Center for Emotional Health PLLC
• Wildflower Collective Counseling
• Wildflower Way Counseling PLLC
• Wildlight Therapy

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, 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 Oct 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.