Healthcare Provider Details

I. General information

NPI: 1174445308
Provider Name (Legal Business Name): THE COTTAGE WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

814 61ST ST
LA GRANGE HIGHLANDS IL
60525-7416
US

IV. Provider business mailing address

814 61ST ST
LA GRANGE HIGHLANDS IL
60525-7416
US

V. Phone/Fax

Practice location:
  • Phone: 708-925-4574
  • Fax:
Mailing address:
  • Phone: 708-925-4574
  • Fax:

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: COURTNEY COLLINS JARVA
Title or Position: OWNER
Credential: LCPC, PMH-C
Phone: 708-925-4574