NPIMap

Organization Active NPI

Therapy Health Clinic LLC

  • Clinical Social Worker
  • Oak Park, IL
National Provider Identifier
1629744099
Registry record updated Aug 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
THERAPY HEALTH CLINIC LLC
Practice address
1010 Lake St Ste 200
Oak Park, IL 60301-1132
Phone
(773) 354-1767
Fax
(844) 444-0221
NPI assigned
Aug 17, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2021

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

Authorized official

Name
Mr. Tony Dwayne Wilson, LCSWNPI 1811170038
Title
Psychotherapist
Phone
(773) 354-1767

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 Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

1010 Lake St Ste 200
Oak Park, IL 60301-1132

Mailing address

921 S Humphrey Ave
Oak Park, IL 60304-1720
Phone (773) 354-1767

National Provider Directory

National Provider Directory

Locations

1010 Lake St
Ste 503
Oak Park, IL 60301
Phone (708) 834-6877

Practitioners & affiliated clinicians

Practitioners 7

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": "1629158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629158400000",
    "number": "1629744099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 S HUMPHREY AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603041720",
            "telephone_number": "773-354-1767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 LAKE ST STE 200",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011132",
            "telephone_number": "773-354-1767",
            "fax_number": "844-444-0221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPY HEALTH CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-17",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "DWAYNE",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "773-354-1767",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; 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.