Neuronoodle Neurofeedback and Coaching LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

NEURONOODLE NEUROFEEDBACK AND COACHING LLC

Practice address

175 E Hawthorne Pkwy Ste 220
Vernon Hills, IL 60061-1432

Phone

(847) 386-1550

NPI assigned

Feb 6, 2020

Last updated

Feb 6, 2020By 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

Mr. William Pete Jansons

Title

Owner

Phone

(847) 922-4776

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1580947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580947200000",
    "number": "1194357228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 GRANBY RD",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451466",
            "telephone_number": "847-922-4776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 E HAWTHORNE PKWY STE 220",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611432",
            "telephone_number": "847-386-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURONOODLE NEUROFEEDBACK AND COACHING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-06",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A",
        "authorized_official_last_name": "JANSONS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "PETE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-922-4776",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "REST",
            "endpointTypeDescription": "RESTful URL",
            "endpoint": "https://neuronoodle.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "175 E Hawthorne Pkwy Ste 220",
            "city": "Vernon Hills",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600611432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• NE Illinois MRI
• Michelle Neff
• Haley Greigh Nelson
• Danielle Julienne Nesbitt, O.D.
• Anna Netzel, LCSW
• Neuropsychiatric Associates of Il SC
• Victoria Thao Nguyen
• Julia Nichols
• Taylor Gabrielle Nichols, PA-C
• Nicolette Komie and Associates

• Mental Health Clinic/Center (Including Community Mental Health Center) in Vernon Hills, IL
• Providers in Vernon Hills, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2020; 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.