NPIMap

Organization Active NPI

Athletic & Therapeutic Institute of Naperville, LLC

  • Physical Therapist
  • Naperville, IL
National Provider Identifier
1194906669
Registry record updated Mar 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ATHLETIC & THERAPEUTIC INSTITUTE OF NAPERVILLE, LLC
Practice address
1212 S Naper Blvd
Suite 104
Naperville, IL 60540-8360
Phone
(630) 369-2340
Fax
(630) 369-2859
NPI assigned
Nov 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 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) 296-2222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

1212 S Naper Blvd
Suite 104
Naperville, IL 60540-8360

Mailing address

4947 Paysphere Cir
Chicago, IL 60674-0049
Phone (630) 783-2001

Other identifiers 1

IdentifierTypeStateIssuer
356148909OtherILDEPARTMENT OF LABOR PROVIDER NUMBER

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
Tax ID family
Ati Holdings LLC146 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 11

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1196035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236124800000",
    "number": "1194906669",
    "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",
            "telephone_number": "630-783-2001",
            "fax_number": "630-633-0117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 S NAPER BLVD",
            "address_2": "SUITE 104",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605408360",
            "telephone_number": "630-369-2340",
            "fax_number": "630-369-2859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHLETIC & THERAPEUTIC INSTITUTE OF NAPERVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-26",
        "last_updated": "2009-03-04",
        "status": "A",
        "authorized_official_last_name": "BOGOVICH",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "630-296-2222"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR PROVIDER NUMBER",
            "identifier": "356148909",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ATI Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.