Phoenix Holistic & Nutritional Center
Organization Active NPI Health & Wellness Coach · Ipava, IL
NPI 1104782689 · NPPES record last updated Dec 29, 2025
Key facts
- NPI
- 1104782689
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Health & Wellness Coach 171400000X
- Legal business name
- PHOENIX HOLISTIC & NUTRITIONAL CENTER
- Practice address
- 10 N Orchard St
Ipava, IL 61441-5289 - Phone
- (309) 204-5133
- NPI assigned
- Dec 29, 2025
- Organization subpart
- No
Authorized official
- Name
- Ms. Tonya L Davis, ND
- Title
- Owner
- Phone
- (331) 264-0736
Practitioners 1
-
Tonya L Davis, ND
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Education Nutritionist |
133NN1002X | |||
| Health & Wellness Coach |
171400000X | Yes | ||
| Reflexologist |
173C00000X | |||
| Peer Specialist |
175T00000X | |||
| Dance Therapist |
225600000X | |||
| Home Delivered Meals | 332U00000X | |||
| Doula |
374J00000X |
Addresses
Primary practice location
10 N Orchard St
Ipava, IL 61441-5289
Mailing address
10 N Orchard St
Ipava, IL 61441-5289
Phone (309) 204-5133
Other providers in Ipava, IL
All providers in Ipava, IL · Health & Wellness Coach in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 29, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.