| Nest Life Illinois, Llc | |
|
9560 140th Ct Apt 301 Orland Park IL 60462-1218 | |
| (727) 201-2389 | |
| Not Available |
| Full Name | Nest Life Illinois, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 9560 140th Ct Apt 301, Orland Park, Illinois |
| Authorized Official Name and Position | Jennifer Phelps (CEO/CO-FOUNDERS) |
| Authorized Official Contact | 7272012389 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nest Life Illinois, Llc 5100 1st Ave N St Petersburg FL 33710-8102 Ph: (727) 201-2389 | Nest Life Illinois, Llc 9560 140th Ct Apt 301 Orland Park IL 60462-1218 Ph: (727) 201-2389 |
| NPI Number | 1346917119 |
|---|---|
| Provider Enumeration Date | 08/27/2021 |
| Last Update Date | 08/27/2021 |
| Certification Date | 08/27/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346917119 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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