Active NPI
Champion Fitness, Inc
- Physical Therapy Clinic/Center
- Streator, IL
National Provider Identifier
1336535582
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Clinic/Center
- Legal business name
- CHAMPION FITNESS, INC
- Practice address
- 119 S Sterling St
Streator, IL 61364-3015 - Phone
- (815) 673-2348
- Fax
- (815) 673-2345
- NPI assigned
- Apr 14, 2015
- Organization subpart
- Yes
- Parent organization
- CHAMPION FITNESS, INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael Cohlman
- Title
- Ceo
- Phone
- (815) 844-5411
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | Primary |
Addresses
Primary practice location
119 S Sterling St
Streator, IL 61364-3015
Mailing address
924 W Custer Ave
Pontiac, IL 61764-1067
Phone (815) 844-5411
National Provider Directory
National Provider Directory- Part of
- Champion Fitness
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Physical Therapy Clinic/Center
- Pontiac, IL
- NPI 1407801012
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428969600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1431648000000",
"number": "1336535582",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "924 W CUSTER AVE",
"city": "PONTIAC",
"state": "IL",
"postal_code": "617641067",
"telephone_number": "815-844-5411",
"fax_number": "815-844-5322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 S STERLING ST",
"city": "STREATOR",
"state": "IL",
"postal_code": "613643015",
"telephone_number": "815-673-2348",
"fax_number": "815-673-2345"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHAMPION FITNESS, INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "CHAMPION FITNESS, INC",
"enumeration_date": "2015-04-14",
"last_updated": "2015-05-15",
"status": "A",
"authorized_official_last_name": "COHLMAN",
"authorized_official_first_name": "MICHAEL",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "815-844-5411"
},
"taxonomies": [
{
"code": "261QP2000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Physical Therapy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Streator, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.