Mind-Full Therapy PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

MIND-FULL THERAPY PLLC

Practice address

18700 Wolf Rd Ste 209
Mokena, IL 60448-8699

Phone

(630) 296-6784

NPI assigned

Aug 23, 2023

Last updated

Aug 23, 2023By 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

Elizabeth Polek, PSYDNPI 1225670243

Title

Partner

Phone

(630) 992-8246

Specialties & licenses 1

Addresses

Locations

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.

• Elizabeth Polek

  • Clinical Psychologist
  • Palos Heights, IL
  • NPI 1225670243
  NPD Authorized official

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

{
    "created_epoch": "1692748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692748800000",
    "number": "1235913864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18700 WOLF RD STE 209",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18700 WOLF RD STE 209",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488699",
            "telephone_number": "630-296-6784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND-FULL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-23",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A",
        "authorized_official_last_name": "POLEK",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "630-992-8246",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Midwest Medical Equipment Solutions, Inc.
• Midwest Minimally Invasive Spine Specialists SC (Minimally Invasive Spine Specialist SC)
• Robert Mihm, RNFA
• Milestone Therapy
• Bailey Marie Milet, MOT, OTR/L
• Mindset Transformations, LLC
• Mindset Transformations, LLC
• Minuteclinic Diagnostic of Illinois PLLC
• Minuteclinic Diagnostic of Illinois PLLC
• Minuteclinic Primary Care Illinois PLLC

• Clinical Psychologist in Mokena, IL
• Providers in Mokena, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.