Bodyworks Medical Center of STC LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

BODYWORKS MEDICAL CENTER OF STC LLC

Practice address

923 S Randall Rd
St Charles, IL 60174-1556

Phone

(239) 260-0530

NPI assigned

Jun 28, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Chanele Smith

Title

Manager

Phone

(239) 260-0530

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1656374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740614400000",
    "number": "1023740198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "923 S RANDALL RD",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601741556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 S RANDALL RD",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601741556",
            "telephone_number": "239-260-0530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODYWORKS MEDICAL CENTER OF STC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-28",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CHANELE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "239-260-0530"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jacob Dalton Boehm, PA-C
• Charia Monique Bolden, CNA
• Bon DDS Dental Studio PC
• Rona Bongat, COTA/L
• Julie E Bonhotal, SLP

• General Practice Physician in St Charles, IL
• Providers in St Charles, IL by specialty
• General Practice Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.