Julie Kimpan Freeman, LMT, BCTMB
Individual provider Active NPI Massage Therapist · Genoa, IL
NPI 1982384251 · NPPES record last updated Jul 21, 2023
Key facts
- NPI
- 1982384251
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 227.016412 (IL)
- Practice address
- 675 Park Ave
Genoa, IL 60135-1100 - Phone
- (815) 693-2075
- NPI assigned
- Jul 21, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 227.016412 | IL | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 227.016412 | IL | Yes |
Addresses
Primary practice location
675 Park Ave
Genoa, IL 60135-1100
Mailing address
675 Park Ave
Genoa, IL 60135-1100
Phone (815) 693-2075
Other providers in Genoa, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2023. 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.