Champion Fitness Inc

LBN: Champion Fitness Inc
Champion Fitness Inc is an health care organization with primary practice located at 924 W Custer Ave , Pontiac IL 61764-1067. The organization recently has only one registered license in Ambulatory Health Care Facilities / Physical Therapy, which is considered as the primary health care specialty. Champion Fitness Inc can be contacted via phone (815) 844-5411, or through Schade, Jeffery C via phone (815) 844-4810.

Contact Information

Primary practice address
924 W Custer Ave Pontiac IL 61764-1067
Phone: (815) 844-5411
Fax: (815) 844-5318
Website:
Map and Directions
Authorized official contact:
Name: Schade, Jeffery C PHYSICAL THERAPIST
Phone: (815) 844-4810

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Physical Therapy 261QP2000X

Profile Details

NPI number 1407801012
LBN Legal business name Champion Fitness Inc
DBA Doing business as
Authorized official Schade, Jeffery C PHYSICAL THERAPIST
Entity Organization
Organization subpart 1 No
Enumeration date May 23rd, 2006
Last updated Oct 19th, 2012 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407801012 NPPES
Illinois Other 5307269 BLUE CROSS BLUE SHIELD

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