Bodyshop Professional Massage Therapy

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

BODYSHOP PROFESSIONAL MASSAGE THERAPY

Practice address

500 Coventry LN Ste 130
Crystal Lake, IL 60014-7578

Phone

(630) 446-0110

NPI assigned

Sep 18, 2024

Organization subpart

No

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

Authorized official

Name

Antionette M Meredith, LMTNPI 1801632716

Title

Licensed Massage Therapist

Phone

(630) 418-4440

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Antionette M Meredith, LMT

  • Massage Therapist
  • Crystal Lake, IL
  • NPI 1801632716
  NPD Authorized official

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

{
    "created_epoch": "1726617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1144057555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 COVENTRY LN STE 130",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147578",
            "telephone_number": "630-446-0110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 COVENTRY LN STE 130",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147578",
            "telephone_number": "630-446-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODYSHOP PROFESSIONAL MASSAGE THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "MEREDITH",
        "authorized_official_first_name": "ANTIONETTE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "LICENSED MASSAGE THERAPIST",
        "authorized_official_telephone_number": "630-418-4440",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Blochwitz, DMD
• Laura S Blumenkamp, PT
• Tessa Blumthal
• Summer Evalyn Schaal Bochat, DPM
• Susan Lynn Bockman, MSN, CNP
• Kimberly A Boersma
• Lisa Bohn, LCSW
• David W Bojan, D.D.S.
• Otilia Boncu, APN, NP-C
• Jenissa Boneta

• Massage Therapist in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Massage Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.