NPIMap

Organization Active NPI

Radiant Minds Institute Corp

  • Multi-Specialty Clinic/Center
  • Tinley Park, IL
National Provider Identifier
1811774946
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
RADIANT MINDS INSTITUTE CORP
Practice address
18501 Maple Creek Dr Ste 900
Tinley Park, IL 60477-6781
Phone
(708) 307-0440
NPI assigned
Sep 12, 2023
Last updated
Feb 25, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Authorized official

Name
Evisha FordNPI 1720570401
Title
Owner
Phone
(708) 798-4200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU
Occupational Therapist 225X00000X NU
Multi-Specialty Clinic/Center 261QM1300X NU Primary
Behavior Analyst 103K00000X NU

Addresses

Primary practice location

18501 Maple Creek Dr Ste 900
Tinley Park, IL 60477-6781

Mailing address

18501 Maple Creek Dr Ste 900
Tinley Park, IL 60477-6781

National Provider Directory

National Provider Directory

Locations

18501 Maple Creek Dr
Ste 900
Tinley Park, IL 60477
Phone (708) 307-0440

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1694476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740441600000",
    "number": "1811774946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18501 MAPLE CREEK DR STE 900",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604776781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18501 MAPLE CREEK DR STE 900",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604776781",
            "telephone_number": "708-307-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIANT MINDS INSTITUTE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-12",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "EVISHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-798-4200"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinley Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; 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.