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KOREN FULLER
NPI 1639019003
Massage Therapist in Coal Valley, IL

Active since March 28, 2026
102 W 1ST AVE, COAL VALLEY, IL 61240(309) 799-7422 Get Directions Write a Review

NPPES record last updated: March 28, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Koren Fuller NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KOREN FULLER (NPI 1639019003) is an individual massage therapist in Coal Valley, Illinois, licensed in Illinois (227023901) and active in the NPI registry since March 2026.

NPPES Registry Identity

NPI1639019003
Entity TypeIndividualFemale
Primary Taxonomy225700000X
Provider Legal NameKOREN FULLER
Location Address102 W 1ST AVECoal Valley, IL 61240-9308
Mailing Address401 Walnut StPort Byron, IL 61275-9559 · (309) 644-9252
Phone(309) 799-7422
Sole ProprietorYes
Enumeration DateMarch 28, 2026
NPPES CertifiedMarch 28, 2026
✔ NPI 1639019003 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225700000X
License✔ Licensed in IL · 227023901
Definition
An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
102 W 1ST AVE, Coal Valley, IL 61240
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Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

COAL VALLEY CHIROPRACTIC CLINIC, INC.
Chiropractor
102 W 1ST AVE
COAL VALLEY, IL 61240
Rock Island County (309) 799-7422
DR. MICHELLE L. FRANKLIN D.C.
Chiropractor
102 W 1ST AVE
COAL VALLEY, IL 61240
Rock Island County (309) 799-7422

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Koren Fuller's NPI number?

The NPI number for Koren Fuller is 1639019003. It was assigned to this individual provider in the NPPES registry on March 28, 2026.

Where is Koren Fuller located?

Koren Fuller practices at 102 W 1st Ave, Coal Valley, IL 61240. The listed phone number is (309) 799-7422.

What is Koren Fuller's specialty?

The primary specialty registered for this NPI is Massage Therapist with taxonomy code 225700000X.

When was this NPI record last updated?

The NPPES record for Koren Fuller was last updated on March 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.