Individual
MS. CHAUNTE WILDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3317 W 95TH ST, EVERGREEN PARK, IL 60805-2243
(708) 529-3011
(708) 529-3207
Mailing address
1133 W 95TH ST, CHICAGO, IL 60643-1405
(773) 779-5432
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
178014767
IL
Other
Enumeration date
05/15/2019
Last updated
06/11/2019
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