MEDICARE: YOUPHORIA HEALTH, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LW0102X	Women's Health Nurse Practitioner
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1346100815
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YOUPHORIA HEALTH, INC.

Provider Business Mailing Address
First Line	:	1930 W MORSE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60626-3112
Country	:	US
Telephone Number	:	917-721-3024
Fax Number	:	773-388-0388

Provider Business Practice Location Address
First Line	:	1930 W MORSE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60626-3112
Country	:	US
Telephone Number	:	917-721-3024
Fax Number	:	773-388-0388

Authorized Official
Title or Position	:	OWNER
Name	:	AIDEN NICHOLSON
Credential	:	APN, CNM
Telephone Number	:	917-721-3024

Provider Enumeration Date	:	11/17/2025
Last Update Date	:	04/07/2026

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Directions to “YOUPHORIA HEALTH, INC. ” Practice Location

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