Organization Active NPI

Medical Mind Clarity Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • New Lenox, IL
National Provider Identifier
1255032579
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MEDICAL MIND CLARITY INC
Practice address
1333 S Schoolhouse Rd Ste 109
New Lenox, IL 60451-2746
Phone
(708) 741-2325
Fax
(888) 207-0577
NPI assigned
Mar 14, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Authorized official

Name
Nina Pope- Osaghae
Title
Director
Phone
(773) 616-4338

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

1333 S Schoolhouse Rd Ste 109
New Lenox, IL 60451-2746

Mailing address

17359 S McKenna Dr
Plainfield, IL 60586-9292
Phone (708) 741-2325

Other practice location 1

14484 John Humphrey Dr
Orland Park, IL 60462-2638
Phone (773) 616-4338

National Provider Directory

National Provider Directory

Locations

1333 S Schoolhouse Rd
Ste 109
New Lenox, IL 60451
Phone (708) 741-2325

14484 John Humphrey Dr
Orland Park, IL 60462
Phone (708) 741-2325

NPI Registry JSON

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

{
    "created_epoch": "1678752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704844800000",
    "number": "1255032579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17359 S MCKENNA DR",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605869292",
            "telephone_number": "708-741-2325",
            "fax_number": "888-207-0577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 S SCHOOLHOUSE RD STE 109",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604512746",
            "telephone_number": "708-741-2325",
            "fax_number": "888-207-0577"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14484 John Humphrey Dr",
            "address_purpose": "LOCATION",
            "city": "Orland Park",
            "state": "IL",
            "postal_code": "604622638",
            "country_code": "US",
            "telephone_number": "773-616-4338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEDICAL MIND CLARITY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-14",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A",
        "authorized_official_last_name": "POPE- OSAGHAE",
        "authorized_official_first_name": "NINA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "773-616-4338"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Lenox, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; 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.