Champion Fitness Inc is a
Clinic/center - Physical Therapy based in Pontiac, Illinois. Champion Fitness Inc is licensed to practice in * (Not Available) (license number ) and their current practice location is
924 W Custer Ave, Pontiac, Illinois. It can be reached at their office (for appointments etc.) via phone at
(815) 844-5411.
NPI number for Champion Fitness Inc is 1407801012 and their current mailing address is 924 W Custer Ave, Pontiac, Illinois. Champion Fitness Inc
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1407801012.
Healthcare Provider's Profile
| Full Name | Champion Fitness Inc |
|---|
| Type | Facility |
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| Speciality | Clinic/center - Physical Therapy |
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| Location | 924 W Custer Ave, Pontiac, Illinois |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1407801012
- Provider Enumeration Date: 05/23/2006
- Last Update Date: 02/10/2025
Medical Identifiers
Medical identifiers for Champion Fitness Inc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1407801012 | NPI | - | NPPES |
| 5307269 | Other | IL | BLUE CROSS BLUE SHIELD |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 225100000X | Physical Therapist | (* (Not Available)) | Secondary |
| 261QP2000X | Clinic/center - Physical Therapy | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Champion Fitness Inc is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Champion Fitness Inc
924 W Custer Ave,
Pontiac, IL 61764-1067
Ph: (815) 844-4690 | Champion Fitness Inc
924 W Custer Ave,
Pontiac, IL 61764-1067
Ph: (815) 844-5411 |
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