Healthcare Provider Details

I. General information

NPI: 1992926455
Provider Name (Legal Business Name): DR. ANNE H. WILEY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4327 N BELL AVE
CHICAGO IL
60618-1609
US

IV. Provider business mailing address

4327 N BELL AVE
CHICAGO IL
60618-1609
US

V. Phone/Fax

Practice location:
  • Phone: 248-250-2508
  • Fax:
Mailing address:
  • Phone: 248-250-2508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number StateIL

VIII. Authorized Official

Name: ANNE H. WILEY
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 248-250-2508