Chicago Mental and Life Wellness Institute

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

CHICAGO MENTAL AND LIFE WELLNESS INSTITUTE

Practice address

8547 S Stony Island Ave
Chicago, IL 60617-2249

Phone

(773) 569-0791

NPI assigned

Nov 10, 2022

Organization subpart

No

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

Authorized official

Name

Tanisha Hines

Title

Administrator

Phone

(773) 569-0791

Specialties & licenses 1

Addresses

Tax ID family

Chicago Mental and Life Wellbeing Institute2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Chicago Mental and Life Wellbeing Institute

  • Community/Behavioral Health Agency
  • Chicago, IL
  • NPI 1225746415
  NPD tax ID

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

{
    "created_epoch": "1668038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683849600000",
    "number": "1093423790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3817 W 85TH PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606523709",
            "telephone_number": "773-569-0791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8547 S STONY ISLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606172249",
            "telephone_number": "773-569-0791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO MENTAL AND LIFE WELLNESS INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-10",
        "last_updated": "2023-05-12",
        "certification_date": "2023-03-23",
        "status": "A",
        "authorized_official_last_name": "HINES",
        "authorized_official_first_name": "TANISHA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "773-569-0791"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chicago Medical Physicians LLC
• Chicago Medical Supplies Enterprise Inc
• Chicago Medical Transportation
• Chicago Meg Center, LLC
• Chicago Mental and Life Wellbeing Institute
• Chicago Mental and Lifewellness Institute
• Chicago Midway Youth Center
• Chicago Mind Health Inc
• Chicago Mindful Psychotherapy, Inc.
• Chicago Mobile Foot Care Limited

• Adolescent and Children Mental Health Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Adolescent and Children Mental Health Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; 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.