Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Fulfilling Life PLLC

Organization Specialist · NPI 1922796408

Fulfilling Life PLLC is a Specialist in Edwardsville, Illinois. Registered with an NPI since 2023.

In the registry since
2023
Specialties on file
2
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3 Club Centre Ct Ste B1
Edwardsville, IL 62025-3519
Phone: (618) 699-4402
Fax: (618) 590-8199
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X
Family Medicine Physician Taxonomy 207Q00000X

Record details

NPI number1922796408
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Di'Ara Woods — Ceo · (314) 749-8906
NPI enumeratedApril 24, 2023
Last updated in NPPESApril 24, 2023
Certification dateApril 24, 2023
Mailing address403 Glen Carbon Rd, Glen Carbon, IL 62034-2965

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