MEDICARE: MINDFUL MATTERING 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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1417827023
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINDFUL MATTERING PLLC

Provider Business Mailing Address
First Line	:	1050 W GEORGE ST APT 309
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-4374
Country	:	US
Telephone Number	:	832-433-8342
Fax Number	:

Provider Business Practice Location Address
First Line	:	1050 W GEORGE ST APT 309
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-4374
Country	:	US
Telephone Number	:	832-433-8342
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MANSI NIKHIL MEHTA
Credential	:
Telephone Number	:	832-433-8342

Provider Enumeration Date	:	11/08/2025
Last Update Date	:	11/08/2025

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