Organization Active NPI

Sophbria Wellness and Behavioral Health PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1093675522
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
SOPHBRIA WELLNESS AND BEHAVIORAL HEALTH PLLC
Practice address
2045 W Grand Ave Ste B
Chicago, IL 60612-1577
Phone
(773) 430-0686
NPI assigned
Nov 17, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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

Authorized official

Name
Monica Cervantes, PMHNP-BCNPI 1356197545
Title
Owner
Phone
(773) 430-0686

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

2045 W Grand Ave Ste B
Chicago, IL 60612-1577

Mailing address

465 W Highplains Rd
Round Lake, IL 60073-4269

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251229000412 IL Part B Supplier - Clinic/Group Practice 0648766758 Receives reassigned benefits from 1 practitioner
Practice locations: Mundelein, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1763337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763337600000",
    "number": "1093675522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 W HIGHPLAINS RD",
            "city": "ROUND LAKE",
            "state": "IL",
            "postal_code": "600734269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 W GRAND AVE STE B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606121577",
            "telephone_number": "773-430-0686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOPHBRIA WELLNESS AND BEHAVIORAL HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-17",
        "last_updated": "2025-11-17",
        "certification_date": "2025-10-31",
        "status": "A",
        "authorized_official_last_name": "CERVANTES",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-430-0686",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.