Basic Information
| Provider Information | |||||||||
| NPI: | 1467942896 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SILBERGLEID | ||||||||
| FirstName: | MINDY | ||||||||
| MiddleName: | ANN | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 639561 | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452639561 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8442477222 | ||||||||
| FaxNumber: | 8475842604 | ||||||||
| Practice Location | |||||||||
| Address1: | 2323 NAPERVILLE RD STE 265 | ||||||||
| Address2: | |||||||||
| City: | NAPERVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605633486 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8442477222 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2018 | ||||||||
| LastUpdateDate: | 07/21/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/21/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 1-20-41827 | IL | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.