1558778381 NPI number — AMERICAN THERAPY PROVIDERS LLC.

Table of content: (NPI 1558778381)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558778381 NPI number — AMERICAN THERAPY PROVIDERS LLC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMERICAN THERAPY PROVIDERS 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:
Provider Other Organization Name Type Code:
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:
1558778381
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/26/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8501 ROB ROY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORLAND PARK
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60462-5957
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
708-261-3803
Provider Business Mailing Address Fax Number:
708-570-2936

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17577 KEDZIE AVE
Provider Second Line Business Practice Location Address:
201
Provider Business Practice Location Address City Name:
HAZEL CREST
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60429-2051
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
708-261-3803
Provider Business Practice Location Address Fax Number:
708-570-2936
Provider Enumeration Date:
07/14/2014

Additional Information

Authorized Official

Authorized Official Last Name:
OSMAN
Authorized Official First Name:
MOHY
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
708-261-3803

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , with the licence number:  000441 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QP2000X , with the licence number: 007373 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 161906098 . This is a "NPI" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




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