1942481411 NPI number — ATHLETIC & THERAPEUTIC INSTITUTE OF NAPERVILLE, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942481411 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:
1942481411
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:
18W431 ROOSEVELT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOMBARD
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60148-4142
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-620-1511
Provider Business Practice Location Address Fax Number:
630-620-1588
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: 356148908 . This is a "DEPARTMENT OF LABOR PROVIDER NUMBER" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




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