Healthcare Provider Details
I. General information
NPI: 1700706538
Provider Name (Legal Business Name): INTERCONNECTIONS PSYCHOTHERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4055 S ROUTE 59
NAPERVILLE IL
60564-5803
US
IV. Provider business mailing address
2501 CHATHAM RD STE N
SPRINGFIELD IL
62704-4188
US
V. Phone/Fax
- Phone: 630-228-9616
- Fax: 630-228-9616
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WENDY
TAYLOR
Title or Position: OWNER
Credential: LMFT
Phone: 630-228-9616