Organization
WILKES WELLNESS SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY WILKES FNP (CEO)
(773) 437-7816
Entity
Organization
Contact information
Practice address
8829 S STATE ST, CHICAGO, IL 60619-6609
(773) 437-7816
Mailing address
8829 S STATE ST, CHICAGO, IL 60619-6609
(773) 437-7816
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
11/10/2014
Last updated
08/14/2015
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