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Individual

LARRY WILKES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
400 W 76TH ST STE 303, CHICAGO, IL 60620-1640
(773) 536-9922
Mailing address
400 W 76TH ST STE 303, CHICAGO, IL 60620-1640
(773) 536-9922

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
277000628
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
277000628
IL

Other

Enumeration date
02/01/2014
Last updated
03/06/2025
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