Healthcare Provider Details

I. General information

NPI: 1538931902
Provider Name (Legal Business Name): MAVA HEALTHCARE SYSTEMS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2023
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

799 ROOSEVELT RD STE 3-03
GLEN ELLYN IL
60137-5920
US

IV. Provider business mailing address

799 ROOSEVELT RD STE 3-03
GLEN ELLYN IL
60137-5920
US

V. Phone/Fax

Practice location:
  • Phone: 708-356-2400
  • Fax: 708-356-2420
Mailing address:
  • Phone: 708-356-2400
  • Fax: 708-356-2339

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 StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: SANIA UMER
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 708-356-2400