Provider Demographics
NPI:1437301819
Name:THE BODY WORKS PHYSICAL THERAPY AND WELLNESS PC
Entity Type:Organization
Organization Name:THE BODY WORKS PHYSICAL THERAPY AND WELLNESS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:ANNA
Authorized Official - Last Name:DOWNS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:618-939-7444
Mailing Address - Street 1:217 WESTVIEW PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IL
Mailing Address - Zip Code:62298-1252
Mailing Address - Country:US
Mailing Address - Phone:618-939-7444
Mailing Address - Fax:618-939-7448
Practice Address - Street 1:217 WESTVIEW PLAZA DR
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IL
Practice Address - Zip Code:62298-1252
Practice Address - Country:US
Practice Address - Phone:618-939-7444
Practice Address - Fax:618-939-7448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070008988261QP2000X
MO2002018374261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL215776Medicare PIN