OrganizationActive
360 Body Wellness Inc
NPI 1679024228 · Internal Medicine Physician · Glen Carbon, IL
Provider details
- NPI number
- 1679024228
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Philip Dudak, Family Nurse Practitioner(314) 753-2233
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(71/100 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
3407 Il State Route 157
Glen Carbon, IL 62034
Phone: (618) 288-3610
Street-level locationGet directions
Mailing address
3407 Il State Route 157
Glen Carbon, IL 62034
Registry dates
- Enumerated
- 2016-10-19
- Last updated
- 2016-10-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.