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360 BODY WELLNESS INC NPI 1679024228


NPI Information

NPI: 1679024228
Provider Name: 360 BODY WELLNESS INC
Classification: Internal Medicine - 207R00000X
Entity Type: Organization
Address:
3407 IL STATE ROUTE 157
GLEN CARBON, IL
ZIP 62034
Phone: (618) 288-3610
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360 BODY WELLNESS INC is an internal medicine in Glen Carbon, IL. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. 360 BODY WELLNESS INC NPI is 1679024228. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3407 IL STATE ROUTE 157
GLEN CARBON, IL
ZIP 62034
Phone: (618) 288-3610

The provider's authorized official is Philip S Dudak .
The authorized official title is Family Nurse Practitioner and has the following contact phone number (314) 753-2233.

The enumeration date for this NPI number is 10/19/2016 and was last updated on 10/19/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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