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General NPI Number Information
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NPI Number | 1295498087
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Entity Type | Organization
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Legal Business Name | NOURISH HEALTHCARE
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Dates
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Enumeration Date | 10/19/2021
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Last Update Date | 10/19/2021
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Provider Practice Location Address
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Address Line | 5117B MAIN ST STE 3
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-4602
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Country | US
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Telephone | 630-442-0169
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Fax | 708-234-7065
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Provider Business Mailing Address
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Address Line | 5117B MAIN ST STE 3
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-4602
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Country | US
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Telephone | 630-442-0169
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Fax | 708-234-7065
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL ROBINSON
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Credential | ND, CNS, LDN
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Telephone | 630-442-0169
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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