360 Body Wellness Inc
NPI 1679024228ActiveOrganization· Internal Medicine· Glen Carbon, IL
Internal Medicine in Glen Carbon, Illinois, registered in NPPES in October 2016. The authorized official on file is Philip S. Dudak, FNP-C, Family Nurse Practitioner.
Overview
| NPI | 1679024228 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 19, 2016 |
| Last updated in NPPES | Oct 19, 2016 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine Primary | 207R00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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