Organization Active NPI

Inner Wisdom Therapy

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1376472415
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
INNER WISDOM THERAPY
Practice address
3432 W Diversey Ave FL 2
Chicago, IL 60647-1221
Phone
(312) 380-1747
NPI assigned
May 15, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2026

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

Authorized official

Name
Christy QuerolNPI 1588338461
Title
Owner
Phone
(786) 325-3006

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

3432 W Diversey Ave FL 2
Chicago, IL 60647-1221

Mailing address

3432 W Diversey Ave FL 2
Chicago, IL 60647-1221
Phone (312) 380-1747

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1778803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778803200000",
    "number": "1376472415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3432 W DIVERSEY AVE FL 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606471221",
            "telephone_number": "312-380-1747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3432 W DIVERSEY AVE FL 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606471221",
            "telephone_number": "312-380-1747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNER WISDOM THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-15",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A",
        "authorized_official_last_name": "QUEROL",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-325-3006"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2026; 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.