Healthcare Provider Details

I. General information

NPI: 1609792928
Provider Name (Legal Business Name): FLORUIT MENTAL WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1247 S 60TH CT
CICERO IL
60804-1006
US

IV. Provider business mailing address

6200 ROOSEVELT RD
OAK PARK IL
60304-2302
US

V. Phone/Fax

Practice location:
  • Phone: 224-619-5065
  • Fax:
Mailing address:
  • Phone: 224-619-5065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MARY J WEBB
Title or Position: THERAPIST
Credential: LCPC
Phone: 224-619-5065