Dr. Alissa Wicklund, PC

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Legal business name

DR. ALISSA WICKLUND, PC

Practice address

333 N Michigan Ave Ste 1801
Chicago, IL 60601-3984

Phone

(312) 345-0933

NPI assigned

Jul 27, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Alissa Wicklund, PHD

Title

President

Phone

(708) 588-9940

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497769459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 DREXEL AVE",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "605255815",
            "telephone_number": "708-588-9940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N MICHIGAN AVE STE 1801",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606013984",
            "telephone_number": "312-345-0933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. ALISSA WICKLUND, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WICKLUND",
        "authorized_official_first_name": "ALISSA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-588-9940",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Neuropsychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Neuropsychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.