| Mindful Psychiatric Services, Mdsc | |
|
1802 N Division St Ste 509 Morris IL 60450-3107 | |
| (815) 941-3882 | |
| (815) 941-3884 |
| Full Name | Mindful Psychiatric Services, Mdsc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1802 N Division St Ste 509, Morris, Illinois |
| Authorized Official Name and Position | James Dyers (PRESIDENT) |
| Authorized Official Contact | 8159413882 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Psychiatric Services, Mdsc 1802 N Division St Ste 509 Morris IL 60450-3107 Ph: (815) 941-3882 | Mindful Psychiatric Services, Mdsc 1802 N Division St Ste 509 Morris IL 60450-3107 Ph: (815) 941-3882 |
| NPI Number | 1801409974 |
|---|---|
| Provider Enumeration Date | 08/28/2020 |
| Last Update Date | 08/28/2020 |
| Certification Date | 08/26/2020 |
| Medicare PECOS PAC ID | 2365858289 |
|---|---|
| Medicare Enrollment ID | O20210301001719 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801409974 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (NU) | Primary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (NU) | Secondary |
| Provider Name | James V Dyers |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861679888 PECOS PAC ID: 8729153051 Enrollment ID: I20080820000516 |
| Provider Name | Victoria Brueggert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992231260 PECOS PAC ID: 1456628924 Enrollment ID: I20170605001725 |
| Provider Name | Beth a Gomez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609263417 PECOS PAC ID: 1052839909 Enrollment ID: I20250515000534 |
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