Provider Demographics
NPI:1265924716
Name:MINDFULNESS INSTITUTE OF NW ILLINOIS
Entity type:Organization
Organization Name:MINDFULNESS INSTITUTE OF NW ILLINOIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:MA BSW
Authorized Official - Phone:815-716-8385
Mailing Address - Street 1:104 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:ROCK FALLS
Mailing Address - State:IL
Mailing Address - Zip Code:61071-1287
Mailing Address - Country:US
Mailing Address - Phone:815-716-8385
Mailing Address - Fax:815-716-8960
Practice Address - Street 1:104 E 3RD ST
Practice Address - Street 2:
Practice Address - City:ROCK FALLS
Practice Address - State:IL
Practice Address - Zip Code:61071-1287
Practice Address - Country:US
Practice Address - Phone:815-716-8385
Practice Address - Fax:815-716-8960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-31
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center