Healthcare Provider Details

I. General information

NPI: 1497650725
Provider Name (Legal Business Name): WILD & WAY THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 W INSTITUTE PL STE 500
CHICAGO IL
60610-8792
US

IV. Provider business mailing address

213 W INSTITUTE PL STE 500
CHICAGO IL
60610-8792
US

V. Phone/Fax

Practice location:
  • Phone: 773-951-4474
  • Fax:
Mailing address:
  • Phone: 773-951-4474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL

VIII. Authorized Official

Name: JENNIFER MORALES-CRYE
Title or Position: OWNER
Credential: LCSW
Phone: 773-951-4474