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General NPI Number Information
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NPI Number | 1841089844
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Entity Type | Organization
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Legal Business Name | MINDFUL WELLNESS COLLECTIVE, LLC
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Dates
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Enumeration Date | 05/05/2025
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 105 N OAK PARK AVE STE 4C
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City | OAK PARK
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State | IL
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Zip | 60301-1364
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Country | US
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Telephone | 773-609-4560
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Fax |
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Provider Business Mailing Address
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Address Line | 1180 PINE ST
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City | BATAVIA
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State | IL
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Zip | 60510-3253
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Country | US
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Telephone | 630-777-7590
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Fax |
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Authorized Official
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Title or Position | OWNER, PHYSICAL THERAPIST
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Name | CHRISTOPHER VOIRIN
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Credential | PT
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Telephone | 773-609-4560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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