Healthcare Provider Details

I. General information

NPI: 1306371422
Provider Name (Legal Business Name): HEALTHY STRIDES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2017
Last Update Date: 01/19/2024
Certification Date: 01/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9013 E SCHOOL RD
ARGENTA IL
62501-8045
US

IV. Provider business mailing address

9013 E SCHOOL RD
ARGENTA IL
62501-8045
US

V. Phone/Fax

Practice location:
  • Phone: 217-383-0065
  • Fax: 217-402-3454
Mailing address:
  • Phone: 217-383-0065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DANIEL GIERS
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: LCPC
Phone: 217-383-0065