Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Phoenix Holistic & Nutritional Center

Organization Nutrition Education Nutritionist · NPI 1104782689

Phoenix Holistic & Nutritional Center is a Nutrition Education Nutritionist in Ipava, Illinois. Registered with an NPI since 2025.

In the registry since
2025
Specialties on file
7

Practice location Address checks out

10 N Orchard St
Ipava, IL 61441-5289
Phone: (309) 204-5133
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Health & Wellness Coach (primary) Taxonomy 171400000X
Nutrition Education Nutritionist Taxonomy 133NN1002X
Reflexologist Taxonomy 173C00000X
Peer Specialist Taxonomy 175T00000X
Dance Therapist Taxonomy 225600000X
Home Delivered Meals Taxonomy 332U00000X
Doula Taxonomy 374J00000X

Record details

NPI number1104782689
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tonya Davis — Owner · (331) 264-0736
NPI enumeratedDecember 29, 2025
Last updated in NPPESDecember 29, 2025
Certification dateDecember 29, 2025
Mailing address10 N Orchard St, Ipava, IL 61441-5289

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