MOBILE MENTAL WELLNESS LLC NPI 1497307045

NPI Information

NPI: 1497307045
Provider Name: MOBILE MENTAL WELLNESS, LLC
Classification: Clinic/Center - 261QM1300X
Specialization: Multi-Specialty
Entity Type: Organization
Address: 10208 S INDIANAPOLIS AVE STE 301
CHICAGO, IL
ZIP 60617
Phone: (866) 413-1988

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NPI Details

MOBILE MENTAL WELLNESS, LLC is a multi-specialty clinic center in Chicago, IL. MOBILE MENTAL WELLNESS, LLC NPI is 1497307045. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

10208 S INDIANAPOLIS AVE STE 301
CHICAGO, IL
ZIP 60617-033
Phone: (866) 413-1988
Fax: (866) 628-8599

The provider's authorized official is Kimberly Travis .
The authorized official title is Owner and has the following contact phone number (866) 413-1988.

The enumeration date for this NPI number is 7/14/2019 and was last updated on 3/5/2021.

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	Primary
1	1041C0700X	Social Worker	Clinical	No
2	103TC0700X	Psychologist	Clinical	No
3	261QM1300X	Clinic/Center	Multi-Specialty	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	361685801001	MEDICAID	ILLINOIS
2	300007929	MEDICAID	INDIANA

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: 3/30/2025

NPI Synchronization or Removal

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