FULFILLING LIFE PLLC
NPI 1922796408
Specialist in Edwardsville, IL
- Organization
- Specialist
About FULFILLING LIFE PLLC
This page provides the complete NPI Profile along with additional information for Fulfilling Life Pllc, a provider established in Edwardsville, Illinois operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1922796408 assigned on April 2023. The practitioner's primary taxonomy code is 174400000X. The provider is registered as an organization and their NPI record was last updated 3 years ago. Fulfilling Life Pllc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Di'ara Woods Pa-c, Clc (Ceo)
- NPI
- 1922796408 Verify this NPI
- Provider Name
- FULFILLING LIFE PLLC
- Entity Type
- Organization
- Location Address
- 3 CLUB CENTRE CT STE B1 EDWARDSVILLE, IL 62025
- Location Phone
- (618) 699-4402
- Location Fax
- (618) 590-8199
- Mailing Address
- 403 GLEN CARBON RD GLEN CARBON, IL 62034
- Mailing Phone
- (314) 749-8906
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 04-24-2023
- Last Update Date
- 04-24-2023
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Specialist
- Taxonomy Code
- 174400000X
- Type
- Other Service Providers
- Taxonomy Description
- An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
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Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1922796408, enumerated as an "organization" on April 24, 2023.
The provider is located at 3 CLUB CENTRE CT STE B1 EDWARDSVILLE, IL 62025 and the phone number is (618) 699-4402.
Specialist with taxonomy code 174400000X.
