Healthcare Provider Details

I. General information

NPI: 1255466488
Provider Name (Legal Business Name): TERRY L WRIGHT PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROOSEVELT RD BLDG. A, STE. 321
GLEN ELLYN IL
60137-5839
US

IV. Provider business mailing address

3206 63RD ST
WOODRIDGE IL
60517-1243
US

V. Phone/Fax

Practice location:
  • Phone: 630-263-2583
  • Fax:
Mailing address:
  • Phone: 630-263-2583
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number071005360
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: