Kimberly Drew Wingler, LMT
Individual provider Active NPI Massage Therapist · Arthur, IL
NPI 1194480889 · NPPES record last updated Nov 8, 2021
Key facts
- NPI
- 1194480889
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 227022381 (IL)
- Practice address
- 2046 Jonathan Creek Rd
Arthur, IL 61911-6108 - Phone
- (217) 962-0614
- NPI assigned
- Nov 8, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 227022381 | IL | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Willow Tree Wellness Center LLC | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 227022381 | IL | Yes |
Addresses
Primary practice location
2046 Jonathan Creek Rd
Arthur, IL 61911-6108
Mailing address
2046 Jonathan Creek Rd
Arthur, IL 61911-6108
Phone (217) 962-0614
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | willowtreewellnesscenter@yahoo.com | Direct |
Other providers in Arthur, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 8, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.