A Beautiful Mind, Inc

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

A BEAUTIFUL MIND, INC

Practice address

5113 S Harper Ave # 2C
Chicago, IL 60615-4119

Phone

(773) 304-3699

NPI assigned

May 31, 2019

Last updated

Dec 8, 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

Chiquita Lee

Title

Ceo

Phone

(773) 304-3699

Specialties & licenses 3

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1559260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638921600000",
    "number": "1851959357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5113 S HARPER AVE # 2C",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154119",
            "telephone_number": "773-304-3699",
            "fax_number": "773-304-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5113 S HARPER AVE # 2C",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154119",
            "telephone_number": "773-304-3699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A BEAUTIFUL MIND, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-31",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "CHIQUITA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "773-304-3699"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "abm2019@abmmh.com",
            "affiliation": "N",
            "address_1": "5113 S Harper Ave # 2C",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606154119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Chicago, IL
• Providers in Chicago, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.