Individual
MR. GARY PAUL WAKEFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW LCSW BCD
Contact information
Practice address
1497 NORTH LAFOX, SOUTH ELGIN, IL 60177-1227
(847) 697-4747
(847) 697-4717
Mailing address
1497 NORTH LAFOX, SOUTH ELGIN, IL 60177-1227
(847) 697-4747
(847) 697-4717
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
IL
1041C0700X
Clinical Social Worker
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04572027
BLUE CROSS BLUE SHIELD
—
Enumeration date
06/08/2006
Last updated
09/11/2025
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