Organization Active NPI

Beaivi Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • La Grange Park, IL
National Provider Identifier
1336000116
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
BEAIVI INC
Practice address
1542 Cleveland Ave
La Grange Park, IL 60526-1308
Phone
(847) 616-8271
NPI assigned
Nov 20, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Nicole Naglich, PMHNP, DNPNPI 1437805199
Title
Owner
Phone
(847) 420-1090

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

1542 Cleveland Ave
La Grange Park, IL 60526-1308

Mailing address

1542 Cleveland Ave
La Grange Park, IL 60526-1308
Phone (847) 616-8271

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251230003562 IL Part B Supplier - Clinic/Group Practice 9638665557 Receives reassigned benefits from 1 practitioner
Practice locations: La Grange Park, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1763596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763596800000",
    "number": "1336000116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1542 CLEVELAND AVE",
            "city": "LA GRANGE PARK",
            "state": "IL",
            "postal_code": "605261308",
            "telephone_number": "847-616-8271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1542 CLEVELAND AVE",
            "city": "LA GRANGE PARK",
            "state": "IL",
            "postal_code": "605261308",
            "telephone_number": "847-616-8271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAIVI INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-20",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A",
        "authorized_official_last_name": "NAGLICH",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-420-1090",
        "authorized_official_credential": "PMHNP, DNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grange Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.