NPIMap

Organization Active NPI

Willow Tree Wellness Center LLC

  • Health Service Clinic/Center
  • Arthur, IL
National Provider Identifier
1316717523
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
WILLOW TREE WELLNESS CENTER LLC
Practice address
2046 Jonathan Creek Rd
Arthur, IL 61911-6108
Phone
(217) 962-0614
NPI assigned
Jan 8, 2024
Last updated
Jan 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Authorized official

Name
Amy Brooke Upchurch
Title
Owner
Phone
(217) 962-0614

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X NU Primary

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

Other identifiers 1

IdentifierTypeStateIssuer
1306215157OtherNPI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1704672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704672000000",
    "number": "1316717523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2046 JONATHAN CREEK RD",
            "city": "ARTHUR",
            "state": "IL",
            "postal_code": "619116108",
            "telephone_number": "217-962-0614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2046 JONATHAN CREEK RD",
            "city": "ARTHUR",
            "state": "IL",
            "postal_code": "619116108",
            "telephone_number": "217-962-0614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW TREE WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-08",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A",
        "authorized_official_last_name": "UPCHURCH",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "BROOKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-962-0614"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1306215157",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arthur, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.