MELLOW MIND LLC NPI 1114793585

NPI Information

  • NPI: 1114793585
  • Provider Name: MELLOW MIND LLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Address: 5113 S HARPER AVE
    CHICAGO, IL
    ZIP 60615
  • Phone: (708) 840-1362

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NPI Details

MELLOW MIND LLC is a family medicine in Chicago, IL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MELLOW MIND LLC NPI is 1114793585. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5113 S HARPER AVE
CHICAGO, IL
ZIP 60615-119
Phone: (708) 840-1362
Fax: (708) 833-7392

The provider's authorized official is Kim Mccoy .
The authorized official title is President and has the following contact phone number (708) 833-7392.

The enumeration date for this NPI number is 11/28/2023 and was last updated on 11/28/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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