Imagine Therapy Mindfulness Healing PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

IMAGINE THERAPY MINDFULNESS HEALING PLLC

Practice address

708 W Grand Ave
Chicago, IL 60654

Phone

(312) 300-2190

NPI assigned

Oct 1, 2021

Last updated

Oct 1, 2021By 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

Chrissa Flannery

Title

Manager

Phone

(708) 337-0642

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 8

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.

• Heather Helene Costello, MD

  • Hospice and Palliative Medicine (Emergency Medicine) Physician
  • Evanston, IL
  • NPI 1245496819
  Medicare reassignment Care Compare group NPD
• Rachel Elana Norris, M.D.

  • Hospice and Palliative Medicine (Emergency Medicine) Physician
  • Chicago, IL
  • NPI 1487825618
  Medicare reassignment Care Compare group NPD
• Erika Steinbrenner, MD

  • Psychiatry Physician
  • Palos Heights, IL
  • NPI 1235592494
  Medicare reassignment Care Compare group NPD
• Hope Elizabeth Williams, LCSW

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1457702094
  Medicare reassignment NPD
• Waleed Ahmed, LSW

  • Social Worker
  • Chicago, IL
  • NPI 1164233359
  NPD
• Sarah Emily Coleman

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1336912914
  NPD (past)
• David C. Evans, LCPC

  • Professional Counselor
  • Inverness, IL
  • NPI 1407863186
  NPD (past)
• Annie Rosenthal, L.C.S.W.

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1215024203
  NPD (past)

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

{
    "created_epoch": "1633046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633046400000",
    "number": "1669144218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 W GRAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60654",
            "telephone_number": "312-300-2190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 W GRAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60654",
            "telephone_number": "312-300-2190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGINE THERAPY MINDFULNESS HEALING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-01",
        "last_updated": "2021-10-01",
        "certification_date": "2021-09-15",
        "status": "A",
        "authorized_official_last_name": "FLANNERY",
        "authorized_official_first_name": "CHRISSA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "708-337-0642"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207PH0002X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Je-Woo Im
• Pil Bin Im, M.D.
• Imagination Grove Play Therapy PLLC
• Imaginative SLP, LLC.
• Imagine Healthcare LLC
• Imaginemd
• Imaginenation ABA LLC
• Tanya Imam, LCSW
• Imani Healthcare LLC
• Manouchehr Imani, MD

• Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2021; 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.