Organization Active NPI

Wiley Family Health Services, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Matteson, IL
National Provider Identifier
1912791575
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
WILEY FAMILY HEALTH SERVICES, LLC
Practice address
20650 S Cicero Ave Unit 493
Matteson, IL 60443-3419
Phone
(708) 664-8888
NPI assigned
Apr 8, 2025
Last updated
Oct 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Authorized official

Name
Laretta Wiley, FNP-BC, PMHNP-BCNPI 1952885949
Title
Owner
Phone
(708) 664-8888

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X
Psychiatric/Mental Health Nurse Practitioner 363LP0808X Primary

Addresses

Primary practice location

20650 S Cicero Ave Unit 493
Matteson, IL 60443-3419

Mailing address

21224 Gray Hawk Dr
Matteson, IL 60443-3314
Phone (708) 664-8888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251217002169 IL Part B Supplier - Clinic/Group Practice 4284129289 Receives reassigned benefits from 1 practitioner
Practice locations: Matteson, IL

National Provider Directory

National Provider Directory

Locations

20650 S Cicero Ave
Unit 493
Matteson, IL 60443
Phone (708) 664-8888

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1744070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761782400000",
    "number": "1912791575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21224 GRAY HAWK DR",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604433314",
            "telephone_number": "708-664-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20650 S CICERO AVE UNIT 493",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604433419",
            "telephone_number": "708-664-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILEY FAMILY HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-08",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A",
        "authorized_official_last_name": "WILEY",
        "authorized_official_first_name": "LARETTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-664-8888",
        "authorized_official_credential": "FNP-BC, PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Matteson, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.