# DEVINE NUTRITION INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982012241
- **Authorized official:** MS. KELLY L DEVINE MS RD CSSD LDN (PRESIDENT)
- **Authorized official phone:** (708) 612-0876

## Contact information

- **Practice address:** 9000 W COLLEGE PKWY, PALOS HILLS, IL 60465-1444
- **Practice address phone:** (708) 608-9014
- **Practice address fax:** (708) 304-3801
- **Mailing address:** 6521 CHARLESTON ST, OAK FOREST, IL 60452-2626
- **Mailing address phone:** (708) 612-0876

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 164004722 | IL | Yes |

## Other

- **Enumeration date:** 07/30/2014
- **Last updated:** 03/10/2026