Healthcare Provider Details
I. General information
NPI: 1881169027
Provider Name (Legal Business Name): NOURISHMENT WORKS PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/03/2018
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3921 N LINCOLN AVE
CHICAGO IL
60613-2417
US
IV. Provider business mailing address
3921 N LINCOLN AVE
CHICAGO IL
60613-2417
US
V. Phone/Fax
- Phone: 872-216-7870
- Fax:
- Phone: 312-380-5344
- Fax: 312-277-0932
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 133NN1002X |
| Taxonomy | Nutrition Education Nutritionist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 172V00000X |
| Taxonomy | Community Health Worker |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174H00000X |
| Taxonomy | Health Educator |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 133V00000X |
| Taxonomy | Registered Dietitian |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KATHRYN
S
MERKLE
Title or Position: FOUNDER
Credential: LCSW, MPH, RDN, LDN
Phone: 312-533-0707