Healthcare Provider Details

I. General information

NPI: 1699680249
Provider Name (Legal Business Name): WONDER WORLD SOCIAL SERVICES NFP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

461 E 111TH ST
CHICAGO IL
60628-4558
US

IV. Provider business mailing address

461 E 111TH ST
CHICAGO IL
60628-4558
US

V. Phone/Fax

Practice location:
  • Phone: 773-840-3277
  • Fax: 773-629-8087
Mailing address:
  • Phone: 773-840-3277
  • Fax: 773-629-8087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TASHA MARIE WEATHERSBY
Title or Position: EXECUTIVE DIRECTOR
Credential: LCSW
Phone: 773-840-3277