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General NPI Number Information
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NPI Number | 1497625248
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Entity Type | Organization
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Legal Business Name | OPEN MIND HEALTH WELLNESS
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Dates
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Enumeration Date | 11/07/2025
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 729 BROOKWOOD TER # 5
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City | OLYMPIA FIELDS
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State | IL
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Zip | 60461-1543
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Country | US
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Telephone | 888-888-8888
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Fax |
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Provider Business Mailing Address
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Address Line | 729 BROOKWOOD TER # 5
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City | OLYMPIA FIELDS
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State | IL
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Zip | 60461-1543
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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 | PRESIDENT
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Name | NEIL WILSON
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Credential | PMHNP
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Telephone | 863-473-2083
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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