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WILLOW WELLNESS CENTER, PLLC
NPI 1154437739
Clinic/Center - Adult Mental Health in Park Ridge, IL

Active since August 23, 2006
2604 DEMPSTER ST STE 401, PARK RIDGE, IL 60068(847) 318-8200(224) 478-0026 Get Directions Write a Review

NPPES record last updated: February 12, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Feb 12, 2025, Nov 6, 2024, Jan 26, 2023 and 1 more (4 updates tracked since 2020).

About Willow Wellness Center, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WILLOW WELLNESS CENTER, PLLC (NPI 1154437739) is a healthcare organization registered as an adult mental health in Park Ridge, Illinois and active in the NPI registry since August 2006. The organization lists Lisa Cecilia Campbell, Co-director, as its authorized official.

NPPES Registry Identity

NPI1154437739
Entity TypeOrganization
Primary Taxonomy261QM0850X
Legal Business NameWILLOW WELLNESS CENTER, PLLC
Location Address2604 DEMPSTER ST STE 401Park Ridge, IL 60068-8428
Mailing Address2604 Dempster St Ste 402Park Ridge, IL 60068-8438 · (847) 318-8200 · Fax (224) 478-0026
Phone(847) 318-8200
Fax(224) 478-0026
Organization SubpartNo
Authorized OfficialLisa Cecilia CampbellCo-director · (847) 318-8200
Enumeration DateAugust 23, 2006
Last NPPES UpdateFebruary 12, 20254 updates tracked since enumeration
NPPES CertifiedFebruary 12, 2025
✔ NPI 1154437739 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Adult Mental HealthAmbulatory Health Care Facilities
Taxonomy Code261QM0850X
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
Also ListedPsychologist · ClinicalTaxonomy 103TC0700X
2604 DEMPSTER ST STE 401, Park Ridge, IL 60068
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Willow Wellness Center, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to Willow Wellness Center, PLLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 5 within 10 miles. They are listed nearest first.

Clinicians, nearest first (6)

Lisa Campbell, PSY.D.
Clinical Psychologist
NPI 1184730764
2604 DEMPSTER ST STE 402
Park Ridge, IL 60068
(847) 318-8200
✔ PECOS✔ Accepts MedicareSame address
Meghan Rivard
Mental Health Counselor
NPI 1588385140
2604 DEMPSTER ST STE 402
Park Ridge, IL 60068
(847) 318-8200
✔ PECOS✔ Accepts MedicareSame address
Robert Campbell, PSY.D., M.DIV.
Clinical Psychologist
NPI 1225375389
1400 RENAISSANCE DR SUITE 401
Park Ridge, IL 60068
(847) 318-8200
✔ PECOS✔ Accepts Medicare0.5 mi
Mary Morag Sutherland, PSY.D.
Clinical Psychologist
NPI 1255651162
1400 RENAISSANCE DR STE 401
Park Ridge, IL 60068
(847) 318-8200
✔ PECOS✔ Accepts Medicare0.5 mi
Noel Widholm, MSW, LCSW
Clinical Social Worker
NPI 1881088912
1655 N ARLINGTON HEIGHTS RD SUITE 102 E
Arlington Heights, IL 60004
(847) 259-8583
✔ PECOS7.8 mi
Caren Jeskey, LCSW
Clinical Social Worker
NPI 1629401120
30 N MICHIGAN AVE STE 1927
Chicago, IL 60602
(312) 583-9642
✔ PECOS✔ Accepts Medicare16 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Willow Wellness Center, PLLC's NPI number?

The NPI number for Willow Wellness Center, PLLC is 1154437739. It was assigned to this organization in the NPPES registry on August 23, 2006.

Where is Willow Wellness Center, PLLC located?

Willow Wellness Center, PLLC is located at 2604 Dempster St Ste 401, Park Ridge, IL 60068. The listed phone number is (847) 318-8200.

What is Willow Wellness Center, PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adult Mental Health, with taxonomy code 261QM0850X.

Is Willow Wellness Center, PLLC enrolled in Medicare?

Yes. Willow Wellness Center, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Willow Wellness Center, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 3 Medicare specialties reassign their Medicare billing to Willow Wellness Center, PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Clinical Psychologist (3), Clinical Social Worker (2) and Mental Health Counselor (1). Of these, 2 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Willow Wellness Center, PLLC was last updated on February 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.