Healthcare Provider Details

I. General information

NPI: 1477476943
Provider Name (Legal Business Name): VITAL MINDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 THOMAS AVE
FOREST PARK IL
60130-1965
US

IV. Provider business mailing address

605 THOMAS AVE
FOREST PARK IL
60130-1965
US

V. Phone/Fax

Practice location:
  • Phone: 925-247-4816
  • Fax:
Mailing address:
  • Phone: 630-634-7872
  • Fax: 630-358-6849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. ANIRUDDHA DEKA
Title or Position: PSYCHIATRIST
Credential: MD
Phone: 630-634-7872