MEDICARE: TOLEDO MENTAL HEALTH CLINIC PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1366326068
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOLEDO MENTAL HEALTH CLINIC PLLC

Provider Business Mailing Address
First Line	:	483 N MULFORD RD STE 8
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61107-5164
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	483 N MULFORD RD STE 8
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61107-5164
Country	:	US
Telephone Number	:	779-770-0512
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MIGUEL ANGEL TOLEDO
Credential	:	LCSW
Telephone Number	:	779-770-0512

Provider Enumeration Date	:	08/05/2025
Last Update Date	:	01/22/2026

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