Provider Demographics
NPI:1265111736
Name:WRIGHT, VERNIE
Entity type:Individual
Prefix:
First Name:VERNIE
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1659 S CALIFORNIA AVE UNIT 4
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60608-2165
Mailing Address - Country:US
Mailing Address - Phone:312-576-0090
Mailing Address - Fax:
Practice Address - Street 1:1S132 SUMMIT AVE STE 205
Practice Address - Street 2:
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-3940
Practice Address - Country:US
Practice Address - Phone:708-414-6842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist