Thomas Joseph Wilda, SOCIAL WORK, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

655 W Irving Park Rd
Suite 202
Chicago, IL 60613-3123

Phone

(773) 528-8075

Fax

(773) 248-3638

NPI assigned

Aug 5, 2006

Sex

Male

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, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629087994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 W IRVING PARK RD",
            "address_2": "SUITE 202",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606133123",
            "telephone_number": "773-528-8075",
            "fax_number": "773-248-3638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W IRVING PARK RD",
            "address_2": "SUITE 202",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606133123",
            "telephone_number": "773-528-8075",
            "fax_number": "773-248-3638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDA",
        "first_name": "THOMAS",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "SOCIAL WORK, MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wild Aster Therapy, PLLC
• Wild Heart Therapy PLLC
• Wild Iris Psychotherapy
• Wild Sun Therapy PLLC
• Wild Table PLLC
• James Demaris Wilde, MA, LCPC
• Mark Wildeboer, PT, DPT, OCS
• Bart Anthony Wilder Jr., DO
• Mya Wilder
• Clare Tucker Wildes

• 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 Jul 8, 2007; 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.