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NPI 1942141445

NPI 1942141445 : MML THERAPY, PLLC : WEST DUNDEE, IL

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General NPI Number Information
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    NPI Number           |    1942141445
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    Entity Type          |    Organization 
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    Legal Business Name  |    MML THERAPY, PLLC 
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Dates
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    Enumeration Date     |    04/01/2026
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    Last Update Date     |    04/01/2026
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Provider Practice Location Address
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    Address Line         |    1829 CANTERFIELD PKWY W 
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    City                 |    WEST DUNDEE
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    State                |    IL
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    Zip                  |    60118-9021
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    Country              |    US
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    Telephone            |    224-223-1144
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    244 S RANDALL RD 
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    City                 |    ELGIN
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    State                |    IL
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    Zip                  |    60123-5529
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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    |    COO
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    Name                 |     RAUL  MANTILLA 
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    Credential           |    
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    Telephone            |    224-223-1144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    
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    License Number State |    
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