Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jaime Renee Mendoza, PMHNP

Individual provider Family Nurse Practitioner · NPI 1689915811

Jaime Renee Mendoza, PMHNP is a Nurse Practitioner in Maryville, Illinois. Qualified in 2012, 14 years ago. Practices with Southern Illinois Associates LLC, a 16-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Illinois.

Years since qualifying
14
Licensed in
IL
In the registry since
2013
Specialties on file
2
What do these letters mean?
PMHNP — Psychiatric-Mental Health Nurse Practitioner
A nurse practitioner specialising in mental health, able to prescribe psychiatric medication.

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Practice location Address checks out

6805 State Route 162 Ste 201
Maryville, IL 62062
Phone: (618) 288-5019
Fax: (618) 288-5059
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 27700144 (IL)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 209010309 (IL)

Record details

NPI number1689915811
Entity typeIndividual (Type 1)
GenderFemale
Credentials PMHNP
Sole proprietorYes
NPI enumeratedMarch 13, 2013
Last updated in NPPESJanuary 21, 2026
Certification dateJanuary 21, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Southern Illinois Associates Llc — 16 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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