OrganizationActive
Whole Body Medical Wellness Ltd
NPI 1336687771 · General Practice Physician · Pontiac, IL
Provider details
- NPI number
- 1336687771
- Entity type
- Organization
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Kim Kidner, Owner(815) 844-4631
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Nurse Practitioner363L00000X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Established profile(70/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
402 N Plum St
Pontiac, IL 61764-1817
Phone: (815) 844-4631
Fax: (815) 844-1942
Street-level locationGet directions
Mailing address
402 N Plum St
Pontiac, IL 61764-1817
Registry dates
- Enumerated
- 2017-02-06
- Last updated
- 2017-02-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.