Healthcare Provider Details

I. General information

NPI: 1316799729
Provider Name (Legal Business Name): A BEAUTIFUL MIND PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2024
Last Update Date: 11/09/2025
Certification Date: 11/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20280 GOVERNORS HWY STE 106
OLYMPIA FIELDS IL
60461-1068
US

IV. Provider business mailing address

6700 167TH ST STE 4
TINLEY PARK IL
60477-2078
US

V. Phone/Fax

Practice location:
  • Phone: 708-729-9006
  • Fax: 708-540-2448
Mailing address:
  • Phone: 708-668-4902
  • 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: MR. JAMES E. YOUNG III
Title or Position: PRACTICE OWNER
Credential: NP-BC
Phone: 708-640-6951