MEDICARE: MIND MAPPING EVALUATIONS OF CHICAGO PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	103TF0200X	Forensic Psychologist
2	103G00000X	Clinical Neuropsychologist
3	103T00000X	Psychologist

General Provider Information

NPI Number	:	1073487096
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIND MAPPING EVALUATIONS OF CHICAGO PLLC

Provider Business Mailing Address
First Line	:	40 E HURON ST STE 304
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-5244
Country	:	US
Telephone Number	:	615-887-6406
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 E HURON ST STE 304
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-5244
Country	:	US
Telephone Number	:	615-887-6406
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JEFFERY GARRISON JR.
Credential	:	PSY.D
Telephone Number	:	615-887-6406

Provider Enumeration Date	:	10/02/2025
Last Update Date	:	12/18/2025

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