Mizani Therapeutic Services, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MIZANI THERAPEUTIC SERVICES, LLC

Practice address

2501 Chatham Rd # 5051
Springfield, IL 62704-4188

Phone

(773) 916-6513

NPI assigned

Aug 15, 2024

Last updated

Sep 4, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Chloe S. Glispie- GoginsNPI 1053992362

Title

Ceo

Phone

(773) 916-6513

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Chloe Shavonne Glispie-Gogins, LCSW

  • Clinical Social Worker
  • Springfield, IL
  • NPI 1053992362
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1723680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725408000000",
    "number": "1013749399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 CHATHAM RD # 5051",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044188",
            "telephone_number": "773-916-6513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 CHATHAM RD # 5051",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044188",
            "telephone_number": "773-916-6513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIZANI THERAPEUTIC SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-15",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A",
        "authorized_official_last_name": "GLISPIE- GOGINS",
        "authorized_official_first_name": "CHLOE",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "773-916-6513"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Christine Mitchell, PA-C
• Kristofer J. Mitchell, M.D.
• Nicole Shontrease Mitchell, CRNA
• Robin Mitchell, LMFT
• Khaled Mitwally, MD
• Audrianna Mizeur
• Robert Mocharnuk, M.D.
• Adrienne Mocogni
• Modern Dental of Springfield PLLC
• Sonya Modi, PHARM.D.

• Clinical Social Worker in Springfield, IL
• Providers in Springfield, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.