Elite Psychiatry and Wellness LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

ELITE PSYCHIATRY AND WELLNESS LLC

Practice address

10010 W 190TH PL
Mokena, IL 60448-8752

Phone

(815) 733-8019

Fax

(815) 733-8019

NPI assigned

Jul 15, 2022

Organization subpart

No

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

Authorized official

Name

Medinat Balogun, PMHNP-BCNPI 1558964239

Title

Owner

Phone

(708) 271-2748

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.

• Medinat Omobolanle Balogun, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Joliet, IL
  • NPI 1558964239
  NPD Authorized official

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

{
    "created_epoch": "1657843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657843200000",
    "number": "1265166177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10010 W 190TH PL",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488752",
            "telephone_number": "815-733-8019",
            "fax_number": "815-733-8019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10010 W 190TH PL",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488752",
            "telephone_number": "815-733-8019",
            "fax_number": "815-733-8019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE PSYCHIATRY AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-15",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A",
        "authorized_official_last_name": "BALOGUN",
        "authorized_official_first_name": "MEDINAT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-271-2748",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Mokena, IL
• Providers in Mokena, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2022; 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.