Provider Demographics
NPI:1275213092
Name:NEUROMIND, INC
Entity Type:Organization
Organization Name:NEUROMIND, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:YES-KWAN
Authorized Official - Last Name:CHIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:224-801-4514
Mailing Address - Street 1:3205 N WILKE RD STE 131
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-0001
Mailing Address - Country:US
Mailing Address - Phone:224-801-4514
Mailing Address - Fax:
Practice Address - Street 1:3205 N WILKE RD STE 131
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-0001
Practice Address - Country:US
Practice Address - Phone:224-801-4514
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty