Provider Demographics
NPI:1376735456
Name:WILSON, TOBI (PHD)
Entity Type:Individual
Prefix:DR
First Name:TOBI
Middle Name:
Last Name:WILSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:394 N ADDISON AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-2308
Mailing Address - Country:US
Mailing Address - Phone:312-420-5177
Mailing Address - Fax:
Practice Address - Street 1:2625 BUTTERFIELD RD
Practice Address - Street 2:STE 103W
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-3418
Practice Address - Country:US
Practice Address - Phone:312-420-5177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-13
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist