Wakeful Practice, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

WAKEFUL PRACTICE, LLC

Doing business as

Wakeful Practice

Practice address

4054 N Lincoln Ave Ste 2
Chicago, IL 60618-3144

Phone

(312) 625-3373

NPI assigned

Aug 13, 2018

Organization subpart

No

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

Authorized official

Name

Amy B. Kallenberg, LCSWNPI 1255649471

Title

Owner/Psychotherapist

Phone

(312) 625-3373

Specialties & licenses 1

Addresses

Other names 1

• Wakeful Practice Doing business as

Locations

Practitioners 1

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

• Amy B. Kallenberg, LCSW

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1255649471
  NPD Authorized official

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

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723161600000",
    "number": "1851870406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4018 N LAWLER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606411733",
            "telephone_number": "312-625-3373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4054 N LINCOLN AVE STE 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606183144",
            "telephone_number": "312-625-3373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKEFUL PRACTICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-13",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A",
        "authorized_official_last_name": "KALLENBERG",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "OWNER/PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "312-625-3373",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wakeful Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Syed Wajid, MD
• Rahila Waka
• Jewel Elizabeth Wakefield, LCSW
• Jordan Wakefield, M.ED., LPC
• Sophia Wakefield
• Karla Wakim, M.D.
• Pierre E Wakim, D.O.
• Lauren S. Wakschlag
• Renee Joanna Wakulski
• Lyla Wakut

• Mental Health Clinic/Center (Including Community Mental Health Center) in Chicago, IL
• Providers in Chicago, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; 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.