Healthcare Provider Details

I. General information

NPI: 1760147581
Provider Name (Legal Business Name): NURTURE SPEECH AND FEEDING THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2021
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3614 N HAMILTON AVE
CHICAGO IL
60618-4915
US

IV. Provider business mailing address

3614 N HAMILTON AVE
CHICAGO IL
60618-4915
US

V. Phone/Fax

Practice location:
  • Phone: 917-719-0424
  • Fax:
Mailing address:
  • Phone: 917-719-0424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: JORDAN BILLS
Title or Position: OWNER/SPEECH-LANGUAGE PATHOLOGIST
Credential: M.A., CCC-SLP
Phone: 773-234-1796