Provider Demographics
NPI:1295498087
Name:NOURISH HEALTHCARE
Entity type:Organization
Organization Name:NOURISH HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:ND, CNS, LDN
Authorized Official - Phone:630-442-0169
Mailing Address - Street 1:5117B MAIN ST STE 3
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-4602
Mailing Address - Country:US
Mailing Address - Phone:630-442-0169
Mailing Address - Fax:708-234-7065
Practice Address - Street 1:5117B MAIN ST STE 3
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-4602
Practice Address - Country:US
Practice Address - Phone:630-442-0169
Practice Address - Fax:708-234-7065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty
No175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty