Individual
DR. NYDIA LELIA WELLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
4019 CHURCH ST, SKOKIE, IL 60076-1773
(847) 676-3440
(847) 676-3486
Mailing address
4019 CHURCH ST, SKOKIE, IL 60076-1773
(847) 676-3440
(847) 676-3486
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01673394
BLUE CROSS AND BLUE SHIEL
IL
Enumeration date
05/29/2007
Last updated
07/08/2007
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