DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: PONDER MENTAL WELLNESS, PLLC

MEDICARE: PONDER MENTAL WELLNESS, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist

General Provider Information

NPI Number : 1790635027
Entity Type Code : Organization
Provider Name (Legal Business Name) : PONDER MENTAL WELLNESS, PLLC
Provider Business Mailing Address
First Line : 5454 S SHORE DR APT 311
Second Line :
City : CHICAGO
State : IL
Zip : 60615-5967
Country : US
Telephone Number : 872-216-3348
Fax Number :
Provider Business Practice Location Address
First Line : 5454 S SHORE DR APT 311
Second Line :
City : CHICAGO
State : IL
Zip : 60615-5967
Country : US
Telephone Number : 872-216-3348
Fax Number :
Authorized Official
Title or Position : CO-OWNER
Name : KHANH NGOC NGHIEM
Credential : PHD
Telephone Number : 872-216-3348
Provider Enumeration Date : 01/28/2026
Last Update Date : 01/28/2026

Similar Medicare Providers

1891464830 — JENNA ELIZABETH RUNCHEY PA-C
Practice Location Address:
675 N SAINT CLAIR ST STE 15-200
CHICAGO, IL
60611-5967
Practice Phone: 312-695-8182
Practice Fax: 312-695-4303
1235002254 — KRISTEN NOELLE SIMONS AUD
Practice Location Address:
675 N SAINT CLAIR ST STE 15-200
CHICAGO, IL
60611-5967
Practice Phone: 312-695-8182
Practice Fax: 312-695-4303
1396735320 — DR. JAMES A BURNS MD
Practice Location Address:
675 N SAINT CLAIR ST STE 15-200
CHICAGO, IL
60611-5967
Practice Phone: 312-695-8182
Practice Fax: 312-695-4303
1396701942 — DR. SANDEEP SAMANT MD
Practice Location Address:
675 N SAINT CLAIR ST STE 15-200
CHICAGO, IL
60611-5967
Practice Phone: 312-695-8182
Practice Fax: 312-695-4303
1861426223 — ALAN MICCO MD
Practice Location Address:
675 N SAINT CLAIR ST STE 15-200
CHICAGO, IL
60611-5967
Practice Phone: 312-695-8182
Practice Fax: 312-695-4303
1952419020 — MS. KRISTIN ANN LARSEN MA, CCC-SLP
Practice Location Address:
675 N SAINT CLAIR ST STE 15-200
CHICAGO, IL
60611-5967
Practice Phone: 312-695-8182
Practice Fax: 312-695-4303

Directions to “PONDER MENTAL WELLNESS, PLLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.