Collective Health Spa, PLLC

Primary specialty

Nutrition Education NutritionistTaxonomy code 133NN1002X

Legal business name

COLLECTIVE HEALTH SPA, PLLC

Practice address

19900 Governors Dr # LL-14
Olympia Fields, IL 60461-1057

Phone

(708) 372-0508

Fax

(855) 487-0292

NPI assigned

Oct 24, 2023

Last updated

Jan 2, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

COLLECTIVE HEALTH SPA, PLLCAs reported in NPPES

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

Authorized official

Name

Toya Lynn Beattie, PBTNPI 1649693235

Title

Manager

Phone

(708) 372-0508

Specialties & licenses 1

Addresses

Other names 1

• COLLECTIVE HEALTH SPA, PLLC Former legal business name

Tax ID family

Phlebotomy Geek Lab LLC2 organizations share this tax ID, including this one

Part of

Phlebotomy Geek Lab LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Phlebotomy Geek Lab, LLC

  • Clinical Medical Laboratory
  • Olympia Fields, IL
  • NPI 1881335255
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Toya Lynn Beattie

  • Phlebotomy Technician
  • Glenwood, IL
  • NPI 1649693235
  NPD Authorized official

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

{
    "created_epoch": "1698105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704153600000",
    "number": "1891567863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19900 GOVERNORS DR # LL-14",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611057",
            "telephone_number": "708-372-0508",
            "fax_number": "855-487-0292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19900 GOVERNORS DR # LL-14",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611057",
            "telephone_number": "708-372-0508",
            "fax_number": "855-487-0292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLECTIVE HEALTH SPA, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLLECTIVE HEALTH SPA, PLLC",
        "enumeration_date": "2023-10-24",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A",
        "authorized_official_last_name": "BEATTIE",
        "authorized_official_first_name": "TOYA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "708-372-0508",
        "authorized_official_credential": "PBT"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COLLECTIVE HEALTH SPA, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Providers in Olympia Fields, IL by specialty
• Nutrition Education Nutritionist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.