Individual
ALYSSA K WILDERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, MA
Contact information
Practice address
611 W JEFFERSON ST STE 201, SHOREWOOD, IL 60404-3772
(630) 243-4396
Mailing address
15209 S LAKESIDE CT, PLAINFIELD, IL 60544-2123
(630) 864-8982
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
178020118
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/14/2022
Last updated
07/13/2025
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