Healthcare Provider Details

I. General information

NPI: 1366172512
Provider Name (Legal Business Name): HEALTHWORKS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2022
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 FRANK SCOTT PKWY W STE 966
BELLEVILLE IL
62223-5000
US

IV. Provider business mailing address

4 COUNTRY CLUB EXECUTIVE PARK
GLEN CARBON IL
62034-1702
US

V. Phone/Fax

Practice location:
  • Phone: 618-310-0273
  • Fax:
Mailing address:
  • Phone: 269-779-9435
  • Fax: 949-889-0764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALICIA MARIE WHORTON
Title or Position: OWNER
Credential: FNP-C
Phone: 269-779-9435