Healing Space, LLC

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

Legal business name

HEALING SPACE, LLC

Practice address

2075 Foxfield Rd
Suite 102
St Charles, IL 60174-1402

Phone

(847) 304-5526

Fax

(630) 549-0527

NPI assigned

Sep 16, 2016

Organization subpart

No

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

Authorized official

Name

Marilyn Mitchell, MDNPI 1851380067

Title

Owner

Phone

(847) 304-5526

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.

• Marilyn L. Mitchell

  • Gynecology Physician
  • St Charles, IL
  • NPI 1851380067
  NPD (past) Authorized official

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

{
    "created_epoch": "1473984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473984000000",
    "number": "1316495534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2075 FOXFIELD RD",
            "address_2": "SUITE 102",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601741402",
            "telephone_number": "847-304-5526",
            "fax_number": "630-549-0527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 FOXFIELD RD",
            "address_2": "SUITE 102",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601741402",
            "telephone_number": "847-304-5526",
            "fax_number": "630-549-0527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING SPACE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-16",
        "last_updated": "2016-09-16",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-304-5526",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Hauk, PSYD
• Cynthia K Hayes
• Molly K. Hayes, DDS
• Kyle Hayles, RBT
• HC DMD Inc
• Healthguard Medical Network SC
• Warren J. Heard Jr., PH.D.
• Heartland Counseling Center, Inc
• Genevieve Rose Hebeka, LCSW
• Brian L Heffelfinger, M.D.

• Gynecology Physician in St Charles, IL
• Providers in St Charles, IL by specialty
• Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2016; 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.