Healthcare Provider Details

I. General information

NPI: 1659211258
Provider Name (Legal Business Name): WILDFLOWER COLLECTIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2931 IMPERIAL CT
FLOSSMOOR IL
60422-2210
US

IV. Provider business mailing address

2931 IMPERIAL CT
FLOSSMOOR IL
60422-2210
US

V. Phone/Fax

Practice location:
  • Phone: 312-288-5690
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. MIALAUNI GRIGGS-HOLKE
Title or Position: OWNER
Credential: PHD, LMFT
Phone: 773-726-7497