Michael Bevan

Individual provider Active NPI Health & Wellness Coach · River Forest, IL

NPI 1104790609 · NPPES record last updated Sep 30, 2025

Key facts

NPI
1104790609
Entity type
Individual (NPI type 1)
Primary specialty
Health & Wellness Coach 171400000X
Practice address
1526 Franklin Ave
River Forest, IL 60305-1043
Phone
(773) 307-7858
NPI assigned
Sep 30, 2025
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Health & Wellness Coach 171400000X Yes

Addresses

Primary practice location

1526 Franklin Ave
River Forest, IL 60305-1043

Mailing address

1526 Franklin Ave
River Forest, IL 60305-1043
Phone (773) 307-7858

Other providers in River Forest, IL

All providers in River Forest, IL · Health & Wellness Coach in Illinois

Sources for this page

Verify at the official NPI Registry.