Organization Active NPI

Athletic & Therapeutic Institute of Naperville, LLC

Doing business as ATI Physical Therapy

  • Physical Therapist
  • Morris, IL
National Provider Identifier
1063669182
Registry record updated Mar 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ATHLETIC & THERAPEUTIC INSTITUTE OF NAPERVILLE, LLC
Doing business as
ATI Physical Therapy
Practice address
201 East U.S. Route 6
Morris, IL 60450
Phone
(815) 416-0046
Fax
(815) 416-0150
NPI assigned
Aug 20, 2008
Last updated
Mar 17, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mark Bogovich
Title
Cfo
Phone
(630) 296-2223

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

201 East U.S. Route 6
Morris, IL 60450

Mailing address

4947 Paysphere Cir
Chicago, IL 60674-0049

Other names 1

  • ATI Physical Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040903000494 IL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8325014020 Receives reassigned benefits from 503 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1219190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237248000000",
    "number": "1063669182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4947 PAYSPHERE CIR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606740049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 EAST U.S. ROUTE 6",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "60450",
            "telephone_number": "815-416-0046",
            "fax_number": "815-416-0150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHLETIC & THERAPEUTIC INSTITUTE OF NAPERVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-20",
        "last_updated": "2009-03-17",
        "status": "A",
        "authorized_official_last_name": "BOGOVICH",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "630-296-2223"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ATI Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Morris, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.