Most Relevant Information
Provider Data
| NPI Number: | 1003511999 |
| Provider Name: | KELSEY WILD |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 149024959 |
Most Important Dates
| Enumeration Date: | 03/31/2023 |
| Last Updated: | 03/31/2023 |
Provider Practice Location
1560 WALL ST STE 204
NAPERVILLE
IL
605631146
Practice Location Phone/Fax
| Phone: | 8155415365 |
| Fax: |
Provider Mailing Location
304 COURTLAND ST
WARREN
IL
610879335
Provider Mailing Phone/Fax
| Phone: | 8155415365 |
| Fax: |