Individual provider Active NPI

Michael James Overturf, ATC

  • Athletic Trainer
  • Oak Brook, IL
National Provider Identifier
1245227933
Registry record updated Jul 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
96001572 Issued in IL
Practice address
625 Enterprise Dr
Oak Brook, IL 60523-8813
Phone
(630) 575-6200
NPI assigned
Sep 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 96001572 IL Primary

Addresses

Primary practice location

625 Enterprise Dr
Oak Brook, IL 60523-8813

Mailing address

2346 Patron LN
Montgomery, IL 60538-3431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
96001572ILMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467763200000",
    "number": "1245227933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2346 PATRON LN",
            "city": "MONTGOMERY",
            "state": "IL",
            "postal_code": "605383431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 ENTERPRISE DR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238813",
            "telephone_number": "630-575-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERTURF",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2016-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "96001572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Brook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.