Wisemind Chicago, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149019761 Issued in IL

Legal business name

WISEMIND CHICAGO, LLC

Practice address

5100 N Ravenswood Ave Ste 211
Chicago, IL 60640-1710

Phone

(773) 320-5168

NPI assigned

Nov 6, 2017

Organization subpart

No

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

Authorized official

Name

Ms. Margo Cohn Pactanac, LCSWNPI 1063794261

Title

Psychotherapist

Phone

(773) 320-5168

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Margo Cohn Pactanac, LCSW

  • Mental Health Counselor
  • Portland, OR
  • NPI 1063794261

  Clinical

  NPD Authorized official

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

{
    "created_epoch": "1509926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509926400000",
    "number": "1710490248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 N RAVENSWOOD AVE STE 211",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401710",
            "telephone_number": "773-320-5168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 N RAVENSWOOD AVE STE 211",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401710",
            "telephone_number": "773-320-5168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISEMIND CHICAGO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-06",
        "last_updated": "2017-11-06",
        "status": "A",
        "authorized_official_last_name": "PACTANAC",
        "authorized_official_first_name": "MARGO",
        "authorized_official_middle_name": "COHN",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "773-320-5168",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149019761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI NUMBER",
            "identifier": "1063794261",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephen R Wise, M.D.
• Xoe A Wise, LSW
• Douglas Wiseman, MD
• Jennifer R Wiseman, MD
• Kevin Christopher Wiseman, DDS
• Lauren Jennifer Wishne, DNP
• Jacqueline M Wisinski, DMD
• Lauren Wiske
• Katie Loretta Wisniewski-Dubiel, DPT
• Adriana Wisniewski, PTA

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2017; 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.