Individual provider · Type 1 NPI

Mya Wilder

Student in an Organized Health Care Education/Training Program · Chicago, IL

NPI number 1093658171 Active

Practice location

1747 W Roosevelt Rd
Chicago, IL 60608-1264

Call (312) 355-1203 Map

Mailing address

2522 W Lawrence Ave Unit 257665
Chicago, IL 60625-8880

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1093658171

Mya Wilder's National Provider Identifier is 1093658171, issued on Apr 13, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Chicago, IL. The record was last updated on Apr 13, 2026.