MEDICARE: WILDFLOWER WAY COUNSELING PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1699613562
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILDFLOWER WAY COUNSELING PLLC

Provider Business Mailing Address
First Line	:	4726 N WINTHROP AVE APT 2
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-5097
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4726 N WINTHROP AVE APT 2
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-5097
Country	:	US
Telephone Number	:	847-345-8141
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER/BUSINESS DIRECTOR
Name	:	BAILEY HICKS
Credential	:	LCSW
Telephone Number	:	847-345-8141

Provider Enumeration Date	:	03/23/2026
Last Update Date	:	03/23/2026

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