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Search › Illinois › 1041C0700X

Ty Wakefield, LCSW

NPI 1386005338 · on the registry since 2016

Practice

Address
75 Executive Dr Ste 315d
Aurora, IL 60504
Phone
(630) 949-3138
Organisation at this address
Evolve Care Inc.
Dpt Holdings Llc
Evolve Care Inc.
Np-Md Practice Pc
Light South Winds, Inc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
25

Registry record

Primary taxonomy
1041C0700X
1041C0700X
Also registered as
101Y00000X
101YM0800X
171M00000X
172V00000X
174H00000X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2024-04-15

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois