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General NPI Number Information
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NPI Number | 1013868371
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Entity Type | Organization
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Legal Business Name | RENEWED MINDS THERAPY & WELLNESS LLC
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Dates
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Enumeration Date | 02/04/2026
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Last Update Date | 02/04/2026
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Provider Practice Location Address
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Address Line | 2623 N MASON AVE
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City | CHICAGO
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State | IL
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Zip | 60639
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Country | US
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Telephone | 773-307-5226
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Fax |
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Provider Business Mailing Address
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Address Line | 7000 W FOREST PRESERVE DR STE 1116
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City | NORRIDGE
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State | IL
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Zip | 60706-7123
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LYNN MARIE WEISHAUPT
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Credential | PSYD
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Telephone | 773-307-5226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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