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 |
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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. |
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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