DEVINE NUTRITION INC – Clinic/Center, NPI 1982012241

DEVINE NUTRITION INC is a healthcare provider. based in Tinley park, Illinois. specializing in Clinic/Center. The organization holds a License No. 164004722 (IL). The NPI Number for DEVINE NUTRITION INC is 1982012241

Main info

Organization
Name
DEVINE NUTRITION INC
NPI
1982012241
Phone
(708) 612-0876
Address
6661 PARKSIDE DR
Authorized Official
MS. KELLY L DEVINE PRESIDENT MS RD CSSD LDN
Enumeration Date
30 July 2014
Last Update Date
10 March 2026
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness85
Years active:11State licenses:1Digital endpointsOther names

Provider Addresses for DEVINE NUTRITION INC

  • 6661 PARKSIDE DR

    TINLEY PARK, IL 604772849

    Phone: (708) 612-0876

    Type: Mailing

  • 9000 W COLLEGE PKWY

    PALOS HILLS, IL 604651444

    Phone: (708) 608-9014

    Fax: (708) 304-3801

    Type: Location

  • 6811 167TH ST STE 6

    TINLEY PARK, IL 604772501

    Phone: (708) 612-0876

    Type: Location

  • 6521 CHARLESTON ST

    OAK FOREST, IL 604522626

    Phone: (708) 612-0876

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-06-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20240604002937OClinic/Group PracticeILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60477)

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Reviews

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Frequently asked questions

How is DEVINE NUTRITION INC identified in CMS data?
CMS-hosted NPPES data lists DEVINE NUTRITION INC with NPI 1982012241.
Does CMS list DEVINE NUTRITION INC as active?
Yes — DEVINE NUTRITION INC is active in the NPI listing used on this page.
What healthcare role does DEVINE NUTRITION INC hold?
Scheduling teams often label DEVINE NUTRITION INC under Clinic/Center. Clinical services aligned with this taxonomy classification.
Where should I expect DEVINE NUTRITION INC on a map?
Expect Tinley Park, Illinois as a primary anchor for DEVINE NUTRITION INC unless the record lists multiple sites.
What does 'Organization' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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