Organization Active NPI

Vivid Mind Psychiatric Services PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Libertyville, IL
National Provider Identifier
1063335636
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
VIVID MIND PSYCHIATRIC SERVICES PLLC
Practice address
1580 S Milwaukee Ave Ste 407
Libertyville, IL 60048-3775
Phone
(224) 300-8372
NPI assigned
Jul 31, 2026
Last updated
Jul 31, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Authorized official

Name
Patrycja Mazur
Title
Pmhnp-BC
Phone
(224) 300-8372

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary

Addresses

Primary practice location

1580 S Milwaukee Ave Ste 407
Libertyville, IL 60048-3775

Mailing address

1580 S Milwaukee Ave Ste 407
Libertyville, IL 60048-3775

National Provider Directory

National Provider Directory

Locations

1580 S Milwaukee Ave
Ste 407
Libertyville, IL 60048
Phone (312) 339-9493

NPI Registry JSON

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

{
    "created_epoch": "1785456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785456000000",
    "number": "1063335636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 S MILWAUKEE AVE STE 407",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 S MILWAUKEE AVE STE 407",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483775",
            "telephone_number": "224-300-8372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVID MIND PSYCHIATRIC SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-31",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A",
        "authorized_official_last_name": "MAZUR",
        "authorized_official_first_name": "PATRYCJA",
        "authorized_official_title_or_position": "PMHNP-BC",
        "authorized_official_telephone_number": "224-300-8372"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2026; 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.