1881875342 NPI number — ATHLETIC & THERAPEUTIC INSTITUTE OF NAPERVILLE, LLC

Table of content: (NPI 1881875342)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881875342 NPI number — ATHLETIC & THERAPEUTIC INSTITUTE OF NAPERVILLE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ATHLETIC & THERAPEUTIC INSTITUTE OF NAPERVILLE, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ATI PHYSICAL THERAPY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881875342
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/04/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4947 PAYSPHERE CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60674-0049
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-783-2001
Provider Business Mailing Address Fax Number:
630-633-0117

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9638 S ROBERTS RD
Provider Second Line Business Practice Location Address:
UNIT B 36
Provider Business Practice Location Address City Name:
HICKORY HILLS
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60457-2238
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
708-237-4270
Provider Business Practice Location Address Fax Number:
708-237-4272
Provider Enumeration Date:
11/26/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BOGOVICH
Authorized Official First Name:
MARK
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
630-296-2222

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 356148918 . This is a "DEPARTMENT OF LABOR PROVIDER NUMBER" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".