| Wise Willow Inc | |
|
10522 S Cicero Ave Ste 304 Oak Lawn IL 60453-5292 | |
| (708) 275-0934 | |
| (888) 419-1594 |
| Full Name | Wise Willow Inc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 10522 S Cicero Ave Ste 304, Oak Lawn, Illinois |
| Authorized Official Name and Position | Timothy M Jenkins (PRESIDENT) |
| Authorized Official Contact | 7082750934 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wise Willow Inc Po Box 764 Manteno IL 60950-0764 Ph: (708) 275-0934 | Wise Willow Inc 10522 S Cicero Ave Ste 304 Oak Lawn IL 60453-5292 Ph: (708) 275-0934 |
| NPI Number | 1992522965 |
|---|---|
| Provider Enumeration Date | 09/23/2024 |
| Last Update Date | 09/23/2024 |
| Certification Date | 09/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992522965 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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