Healthcare Provider Details

I. General information

NPI: 1548107568
Provider Name (Legal Business Name): KWR PRACTICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 EAST MAXON LANE
STREAMWOOD IL
60107
US

IV. Provider business mailing address

1764 W WISE RD # 1026
SCHAUMBURG IL
60193-3524
US

V. Phone/Fax

Practice location:
  • Phone: 224-310-9505
  • Fax:
Mailing address:
  • Phone: 224-310-9505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY WILSON
Title or Position: OWNER/LCPC
Credential: OWNER/LCPC
Phone: 224-310-9505