Healthcare Provider Details

I. General information

NPI: 1710783170
Provider Name (Legal Business Name): ATLAS MENTAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2025
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 S 2ND ST STE 112
ELKHART IN
46516-3238
US

IV. Provider business mailing address

1027 CLINTON ST
OTTAWA IL
61350-2039
US

V. Phone/Fax

Practice location:
  • Phone: 773-453-5333
  • Fax: 708-808-2028
Mailing address:
  • Phone: 773-453-5333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: TOSHETA GREENFIELD
Title or Position: MEMBER
Credential:
Phone: 773-453-5333