Organization
DEVINE NUTRITION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KELLY L DEVINE MS RD CSSD LDN (PRESIDENT)
(708) 612-0876
Entity
Organization
Contact information
Practice address
9000 W COLLEGE PKWY, PALOS HILLS, IL 60465-1444
(708) 608-9014
(708) 304-3801
Mailing address
6521 CHARLESTON ST, OAK FOREST, IL 60452-2626
(708) 612-0876
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
164004722
IL
Other
Enumeration date
07/30/2014
Last updated
03/10/2026
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