Provider Demographics
NPI:1407676851
Name:CHICAGO MIND SOLUTIONS - MKE LLC
Entity type:Organization
Organization Name:CHICAGO MIND SOLUTIONS - MKE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JARED
Authorized Official - Middle Name:
Authorized Official - Last Name:TREIBER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:917-400-9222
Mailing Address - Street 1:3970 N OAKLAND AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SHOREWOOD
Mailing Address - State:WI
Mailing Address - Zip Code:53211-2291
Mailing Address - Country:US
Mailing Address - Phone:414-231-9108
Mailing Address - Fax:
Practice Address - Street 1:3970 N OAKLAND AVE STE 200
Practice Address - Street 2:
Practice Address - City:SHOREWOOD
Practice Address - State:WI
Practice Address - Zip Code:53211-2291
Practice Address - Country:US
Practice Address - Phone:414-231-9108
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-11
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty