DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: WILD SUN THERAPY PLLC

MEDICARE: WILD SUN THERAPY PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1225975840
Entity Type Code : Organization
Provider Name (Legal Business Name) : WILD SUN THERAPY PLLC
Provider Business Mailing Address
First Line : 213 W INSTITUTE PL STE 500
Second Line :
City : CHICAGO
State : IL
Zip : 60610-8792
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 213 W INSTITUTE PL STE 500
Second Line :
City : CHICAGO
State : IL
Zip : 60610-8792
Country : US
Telephone Number : 224-616-0614
Fax Number :
Authorized Official
Title or Position : OWNER
Name : ELLA PETERSEN
Credential : LCSW
Telephone Number : 224-616-0614
Provider Enumeration Date : 05/01/2026
Last Update Date : 05/01/2026

Similar Medicare Providers

1528905551 — STAMMTISCH THERAPY LLC
Practice Location Address:
213 W INSTITUTE PL STE 500
CHICAGO, IL
60610-8792
Practice Phone: 312-847-4421
Practice Fax:
1295672996 — COLLECTIVE SHAKTI COUNSELING PC
Practice Location Address:
213 W INSTITUTE PL STE 500
CHICAGO, IL
60610-8792
Practice Phone: 530-447-0111
Practice Fax:
1821603200 — CHANDRA SHANMUGAVEL
Practice Location Address:
213 W INSTITUTE PL STE 500
CHICAGO, IL
60610-8792
Practice Phone: 530-447-0111
Practice Fax:
1942936661 — CAMERON STAMM
Practice Location Address:
213 W INSTITUTE PL STE 500
CHICAGO, IL
60610-8792
Practice Phone: 312-847-4421
Practice Fax:
1114755014 — MIND-BODY PEDIATRIC PSYCHIATRY
Practice Location Address:
213 W INSTITUTE PL STE 500
CHICAGO, IL
60610-8792
Practice Phone: 630-283-2107
Practice Fax:
1780520726 — HARBORLIGHT PSYCHIATRIC N.P. SERVICES PLLC
Practice Location Address:
213 W INSTITUTE PL STE 500
CHICAGO, IL
60610-8792
Practice Phone: 773-839-5328
Practice Fax:

Directions to “WILD SUN THERAPY PLLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.