Organization
MIRA MEDICAL ASSOCIATES, PLLC
Active
Parent organization
MIRA NEURO BEHAVORIAL HEALTH CARE, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MIRA NEURO BEHAVORIAL HEALTH CARE, LLC
Authorized official
CHRISTOPHER HIGGINS (PRESIDENT)
(708) 726-6472
Entity
Organization
Contact information
Practice address
6775 PROSPERI DR, TINLEY PARK, IL 60477-4789
(708) 726-6472
(708) 671-8446
Mailing address
6775 PROSPERI DR, TINLEY PARK, IL 60477-4789
(708) 726-6472
(708) 671-8446
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
133N00000X
Nutritionist
—
—
2080A0000X
Pediatric Adolescent Medicine Physician
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
01/25/2023
Last updated
01/25/2023
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