NPIMap

Organization Active NPI

Bodyworks Medical Center PLLC

  • General Practice Physician
  • Carol Stream, IL
National Provider Identifier
1144700105
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
BODYWORKS MEDICAL CENTER PLLC
Practice address
270 W Army Trail Road
Carol Stream, IL 60188-9368
Phone
(630) 517-5674
NPI assigned
Aug 20, 2018
Last updated
Aug 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

270 W Army Trail Road
Carol Stream, IL 60188-9368

Mailing address

270 W Army Trail Road
Carol Stream, IL 60188-9368
Phone (630) 517-5674

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20181126000037 IL Part B Supplier - Clinic/Group Practice 6507110905 Receives reassigned benefits from 12 practitioners
Practice locations: Carol Stream, IL
O20200416002382 IL DME Supplier - Physician - General Practice 6507110905 Practice locations: Carol Stream, IL

National Provider Directory

National Provider Directory

Locations

270 W Army Trail Rd
Carol Stream, IL 60188
Phone (630) 517-5674

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1534723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724284800000",
    "number": "1144700105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 W ARMY TRAIL ROAD",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601889368",
            "telephone_number": "630-517-5674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 W ARMY TRAIL ROAD",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601889368",
            "telephone_number": "630-517-5674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODYWORKS MEDICAL CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-20",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "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": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carol Stream, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.