NPIMap

Organization Active NPI

Attentive Individualized Management Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Sugar Grove, IL
National Provider Identifier
1497244859
Registry record updated Aug 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
ATTENTIVE INDIVIDUALIZED MANAGEMENT PHYSICAL THERAPY, LLC
Practice address
330B Division Dr
Sugar Grove, IL 60554
Phone
(630) 777-3141
Fax
(630) 777-3142
NPI assigned
May 1, 2018
Last updated
Aug 31, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2018

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

Authorized official

Name
Susan Jean Johnson, PTNPI 1821049628
Title
Owner
Phone
(630) 853-2858

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU Primary

Addresses

Primary practice location

330B Division Dr
Sugar Grove, IL 60554

Mailing address

330B Division Dr
Sugar Grove, IL 60554-9800
Phone (630) 777-3141

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180630000021 IL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5395091581 Receives reassigned benefits from 10 practitioners
Practice locations: Sugar Grove, IL; Batavia, IL

National Provider Directory

National Provider Directory

Locations

1605 W Wilson St
Ste 119
Batavia, IL 60510
Phone (630) 761-9702

330 Division Dr
Sugar Grove, IL 60554
Phone (630) 777-3141

330 Division Dr
Ste Be
Sugar Grove, IL 60554
Phone (630) 777-3141

330B Division Dr
Sugar Grove, IL 60554
Phone (630) 777-3141

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1525132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535673600000",
    "number": "1497244859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330B DIVISION DR",
            "city": "SUGAR GROVE",
            "state": "IL",
            "postal_code": "605549800",
            "telephone_number": "630-777-3141",
            "fax_number": "630-777-3142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330B DIVISION DR",
            "city": "SUGAR GROVE",
            "state": "IL",
            "postal_code": "60554",
            "telephone_number": "630-777-3141",
            "fax_number": "630-777-3142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATTENTIVE INDIVIDUALIZED MANAGEMENT PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-01",
        "last_updated": "2018-08-31",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-853-2858",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2018; 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.