Provider Demographics
NPI:1194020123
Name:WOOD, TERRILYNN (MED)
Entity Type:Individual
Prefix:MRS
First Name:TERRILYNN
Middle Name:
Last Name:WOOD
Suffix:
Gender:F
Credentials:MED
Other - Prefix:MRS
Other - First Name:TERRILYNN
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MASTERS OF EDUCATION
Mailing Address - Street 1:3651 W 85TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60652-3701
Mailing Address - Country:US
Mailing Address - Phone:773-991-9879
Mailing Address - Fax:773-789-2241
Practice Address - Street 1:3651 W 85TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60652-3701
Practice Address - Country:US
Practice Address - Phone:773-991-9879
Practice Address - Fax:773-789-2241
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-23
Last Update Date:2011-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist