Devine Nutrition INC
Clinic/Center in Palos Hills, IL. Organization (NPI-2).
NPI number1982012241
StatusActive
Last updated in NPPESMar 10, 2026
Details
- NPI
- 1982012241
- Entity type
- Organization (NPI-2)
- Legal business name
- Devine Nutrition INC
- Organization subpart
- No
- Enumeration date
- Jul 30, 2014
- Certification date
- Mar 10, 2026
- Last updated
- Mar 10, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | 164004722 | IL | Yes |
Practice location
9000 W College PkwyPalos Hills, IL 60465-1444
Phone 708-608-9014 · Fax 708-304-3801
Mailing address
6521 Charleston StOak Forest, IL 60452-2626
Phone 708-612-0876
Authorized official
Kelly L Devine
President
7086120876
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