Healthcare Provider Details

I. General information

NPI: 1609733393
Provider Name (Legal Business Name): A HEALING PLACE SPRINGFIELD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 CLOCK TOWER DR STE A
SPRINGFIELD IL
62704-8900
US

IV. Provider business mailing address

1001 CLOCK TOWER DR STE A
SPRINGFIELD IL
62704-8900
US

V. Phone/Fax

Practice location:
  • Phone: 217-583-4242
  • Fax: 217-629-5116
Mailing address:
  • Phone: 217-583-4242
  • Fax: 217-629-5116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: ELLIOTT W. CHALLANDES
Title or Position: OWNER/MANAGER
Credential: LMT
Phone: 217-416-7649