Healthcare Provider Details

I. General information

NPI: 1871408013
Provider Name (Legal Business Name): MINDFUL MINDSET WELLNESS CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1260 IROQUOIS AVE STE 104
NAPERVILLE IL
60563-8547
US

IV. Provider business mailing address

1260 IROQUOIS AVE STE 104
NAPERVILLE IL
60563-8547
US

V. Phone/Fax

Practice location:
  • Phone: 708-480-2048
  • Fax: 708-480-0710
Mailing address:
  • Phone: 708-480-2048
  • Fax: 708-480-0710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NADER F JOUDEH
Title or Position: OWNER
Credential:
Phone: 708-480-2048