Mosaic Wholeness Center LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

MOSAIC WHOLENESS CENTER LLC

Practice address

4200 Euclid Ave Ste 104
Rolling Meadows, IL 60008-2083

Phone

(847) 917-9974

NPI assigned

Sep 4, 2025

Organization subpart

No

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

Authorized official

Name

Luis San Roman, LCPCNPI 1124480595

Title

Owner of Practice

Phone

(512) 368-6408

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 4

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

• Luis San Roman, LCPC

  • Professional Counselor
  • Lake Bluff, IL
  • NPI 1124480595
  Medicare reassignment Care Compare group NPD Authorized official
• Bonnie Mija Kim, LCPC

  • Counselor
  • Rolling Meadows, IL
  • NPI 1336011287
  Medicare reassignment Care Compare group NPD
• Jessica Marie Renteria

  • Professional Counselor
  • Rolling Meadows, IL
  • NPI 1518829241
  NPD
• Wesley Weitsen Liou

  • Mental Health Counselor
  • Rolling Meadows, IL
  • NPI 1821929910
  NPD (past)

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

{
    "created_epoch": "1756944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756944000000",
    "number": "1245110782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 EUCLID AVE STE 104",
            "city": "ROLLING MEADOWS",
            "state": "IL",
            "postal_code": "600082083",
            "telephone_number": "847-917-9974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 EUCLID AVE STE 104",
            "city": "ROLLING MEADOWS",
            "state": "IL",
            "postal_code": "600082083",
            "telephone_number": "847-917-9974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSAIC WHOLENESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-04",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A",
        "authorized_official_last_name": "SAN ROMAN",
        "authorized_official_first_name": "LUIS",
        "authorized_official_title_or_position": "OWNER OF PRACTICE",
        "authorized_official_telephone_number": "512-368-6408",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frank Moens, PT
• Liara Montesano, PSYD
• Roberto Carlos Montoya Barraza, MD
• Steven Donghun Moon
• Denisse Morales
• Sylwia Mozdzen, PHARMD
• Michaela Mueller
• Imman Musa, PH.D.
• Inyoung NA, DO
• Paige B Nadherny, OTR/L

• Professional Counselor in Rolling Meadows, IL
• Providers in Rolling Meadows, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.