Organization
INTERMIND WELLNESS INC
Active
Organization
INTERMIND WELLNESS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY DAVIS APRN (CEO)
(312) 967-7214
Entity
Organization
Contact information
Practice address
1137 W 127TH ST, CALUMET PARK, IL 60827-6537
(312) 967-7214
Mailing address
1137 W 127TH ST, CALUMET PARK, IL 60827-6537
(312) 967-7214
Taxonomy
Speciality
Code
Description
License number
State
202D00000X
Integrative Medicine Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
03/14/2024
Last updated
03/14/2024
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