NPIMap

Organization Active NPI

Mind Body Behavioral Health

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1164299681
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
MIND BODY BEHAVIORAL HEALTH
Practice address
230 E Ohio St Ste 4101768
Chicago, IL 60611-3265
Phone
(708) 606-1147
NPI assigned
Dec 5, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Authorized official

Name
Dayna Long, NPNPI 1417359266
Title
Owner of Practice
Phone
(708) 606-1147

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

230 E Ohio St Ste 4101768
Chicago, IL 60611-3265

Mailing address

230 E Ohio St Ste 4101768
Chicago, IL 60611-3265
Phone (708) 606-1147

National Provider Directory

National Provider Directory

Locations

230 E Ohio St
Ste 4101768
Chicago, IL 60611
Phone (708) 606-1147

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1701734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701734400000",
    "number": "1164299681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 E OHIO ST STE 4101768",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113265",
            "telephone_number": "708-606-1147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 E OHIO ST STE 4101768",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113265",
            "telephone_number": "708-606-1147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND BODY BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-05",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "DAYNA",
        "authorized_official_title_or_position": "OWNER OF PRACTICE",
        "authorized_official_telephone_number": "708-606-1147",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "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 Dec 5, 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.