PHOENIX HOLISTIC & NUTRITIONAL CENTER NPI 1104782689

NPI Information

  • NPI: 1104782689
  • Provider Name: PHOENIX HOLISTIC & NUTRITIONAL CENTER
  • Classification: Health and Wellness Coach - 171400000X
  • Entity Type: Organization
  • Address: 10 N ORCHARD ST
    IPAVA, IL
    ZIP 61441
  • Phone: (309) 204-5133

Map and Directions

Get Directions

NPI Details

PHOENIX HOLISTIC & NUTRITIONAL CENTER is a health and wellness coach in Ipava, IL. The provider is the Health & Wellness Coach is trained in motivational theories, strategies, and communication techniques, which are used to assist patients to develop intrinsic motivation and obtain skills to create sustainable change for improved health and well-being. Health and wellness coaching is a patient-centered approach wherein patients at least partially determine their goals, use self-discovery or active learning processes together with content education to work toward their goals, and self-monitor behaviors to increase accountability, all within the context of an interpersonal relationship with a coach. PHOENIX HOLISTIC & NUTRITIONAL CENTER NPI is 1104782689. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

10 N ORCHARD ST
IPAVA, IL
ZIP 61441-289
Phone: (309) 204-5133

The provider's authorized official is Tonya L Davis .
The authorized official title is Owner and has the following contact phone number (331) 264-0736.

The enumeration date for this NPI number is 12/29/2025 and was last updated on 12/29/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1133NN1002XNutritionistNutrition, EducationNo
2173C00000XReflexologistNo
3175T00000XPeer SpecialistNo
4225600000XDance TherapistNo
5332U00000XHome Delivered MealsNo
6374J00000XDoulaNo
7171400000XHealth and Wellness CoachYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.