Wise Willow Inc

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

WISE WILLOW INC

Practice address

10522 S Cicero Ave Ste 304
Oak Lawn, IL 60453-5292

Phone

(708) 275-0934

Fax

(888) 419-1594

NPI assigned

Sep 23, 2024

Organization subpart

No

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

Authorized official

Name

Timothy M Jenkins, LCPCNPI 1043378250

Title

President

Phone

(708) 275-0934

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

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

• Timothy Michael Jenkins, M.A.

  • Professional Counselor
  • Oak Forest, IL
  • NPI 1043378250
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1727049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737504000000",
    "number": "1992522965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 764",
            "city": "MANTENO",
            "state": "IL",
            "postal_code": "609500764",
            "telephone_number": "708-275-0934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10522 S CICERO AVE STE 304",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604535292",
            "telephone_number": "708-275-0934",
            "fax_number": "888-419-1594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISE WILLOW INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-23",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-275-0934",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tom Wilson
• Win Myint MD PC
• Windy City Pain Relief, S.C.
• Elisa Wing, M.D.
• Brittany M Wirkus, APN
• Lauren Wislocki, FNP-BC
• Katherine A Wittle, RN
• Kimberly Wittmayer, APRN
• Helen T Wolf
• Katie Wolff, APN

• Adult Mental Health Clinic/Center in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Adult Mental Health Clinic/Center in Illinois

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