Healthcare Provider Details

I. General information

NPI: 1093668592
Provider Name (Legal Business Name): COPIOUS MIND BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2026
Last Update Date: 02/16/2026
Certification Date: 02/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 E NORTHWEST HWY
DES PLAINES IL
60016-2290
US

IV. Provider business mailing address

1755 ASH ST
DES PLAINES IL
60018-2158
US

V. Phone/Fax

Practice location:
  • Phone: 224-354-1321
  • Fax: 224-354-1586
Mailing address:
  • Phone: 224-354-1321
  • Fax: 224-354-1586

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: AMINAT ADEBARE
Title or Position: OWNER
Credential: NURSE PRACTITIONER
Phone: 773-698-9036