Individual
THERESA L WYCKLENDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
1000 BURR RIDGE PKWY STE 201, BURR RIDGE, IL 60527-0864
(312) 818-4650
(855) 618-2629
Mailing address
PO BOX 40412, BELFAST, ME 04915-1255
(312) 818-4650
(855) 618-2629
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11060-033
WI
363LC0200X
Critical Care Medicine Nurse Practitioner
1716711
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100174297
—
WI
Enumeration date
06/09/2021
Last updated
09/29/2025
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