Individual
SAMANTHA WILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9500 BORMET DR STE 304, MOKENA, IL 60448-8399
(815) 469-1500
Mailing address
9500 BORMET DR STE 304, MOKENA, IL 60448-8399
(815) 469-1500
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-61021
IL
106S00000X
Behavior Technician
—
—
Other
Enumeration date
06/18/2021
Last updated
06/17/2026
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