Healthcare Provider Details

I. General information

NPI: 1982466751
Provider Name (Legal Business Name): WILLWOOD CONSULTING SERVICES PLLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2024
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 E PERSHING RD STE 101
CHICAGO IL
60653-1531
US

IV. Provider business mailing address

4919 S VINCENNES AVE UNIT 1
CHICAGO IL
60615-3200
US

V. Phone/Fax

Practice location:
  • Phone: 773-234-8340
  • Fax:
Mailing address:
  • Phone: 248-747-1132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code405300000X
TaxonomyPrevention Professional
License Number
License Number StateNULL

VIII. Authorized Official

Name: TREASYRI WILLIAMS WOOD
Title or Position: CEO
Credential: SLPD
Phone: 248-747-1132