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General NPI Number Information
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NPI Number | 1902590375
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Entity Type | Organization
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Legal Business Name | MIND ALIGN LLC
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Dates
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Enumeration Date | 06/07/2023
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Last Update Date | 08/29/2023
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Provider Practice Location Address
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Address Line | 760 MCARDLE DR STE D
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City | CRYSTAL LAKE
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State | IL
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Zip | 60014-8149
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Country | US
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Telephone | 847-254-6195
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Fax |
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Provider Business Mailing Address
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Address Line | 760 MCARDLE DR STE D
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City | CRYSTAL LAKE
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State | IL
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Zip | 60014-8149
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Country | US
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Telephone | 847-254-6195
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | ALLYSON GUZMAN MONELLI
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Credential | APRN, FNP-BC, FPA
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Telephone | 847-254-6195
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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