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

Koren Fuller

Individual provider Massage Therapist · NPI 1639019003

Koren Fuller is a Massage Therapist in Coal Valley, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2026

Practice location Address checks out

102 W 1st Ave
Coal Valley, IL 61240-9308
Phone: (309) 799-7422
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Massage Therapist (primary) Taxonomy 225700000X · Licence 227023901 (IL)

Record details

NPI number1639019003
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMarch 28, 2026
Last updated in NPPESMarch 28, 2026
Certification dateMarch 28, 2026
Mailing address401 Walnut St, Port Byron, IL 61275-9559