Provider Demographics
NPI:1841089844
Name:MINDFUL WELLNESS COLLECTIVE, LLC
Entity type:Organization
Organization Name:MINDFUL WELLNESS COLLECTIVE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:VOIRIN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:773-609-4560
Mailing Address - Street 1:1180 PINE ST
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:IL
Mailing Address - Zip Code:60510-3253
Mailing Address - Country:US
Mailing Address - Phone:630-777-7590
Mailing Address - Fax:
Practice Address - Street 1:105 N OAK PARK AVE STE 4C
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1364
Practice Address - Country:US
Practice Address - Phone:773-609-4560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-05
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty