Provider Demographics
NPI:1609645894
Name:WONDER INSTITUTE FOR PSYCHOLOGICAL HEALTH, INC.
Entity type:Organization
Organization Name:WONDER INSTITUTE FOR PSYCHOLOGICAL HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:630-217-3094
Mailing Address - Street 1:212 HILLSIDE CT
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-5572
Mailing Address - Country:US
Mailing Address - Phone:630-217-3094
Mailing Address - Fax:
Practice Address - Street 1:212 HILLSIDE CT
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-5572
Practice Address - Country:US
Practice Address - Phone:630-217-3094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-28
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty