Nicholas E Grahovec, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

096002615 Issued in IL

Practice address

1425 W Lincoln Hwy
Dekalb, IL 60115-2825

Phone

(815) 753-1400

NPI assigned

Oct 11, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northern Illinois University-Physical Therapy

  • Physical Therapy Clinic/Center
  • Dekalb, IL
  • NPI 1821251430
  NPD (past)

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

{
    "created_epoch": "1318291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645747200000",
    "number": "1568746477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 W LINCOLN HWY",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601152825",
            "telephone_number": "815-753-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 W LINCOLN HWY",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601152825",
            "telephone_number": "815-753-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHOVEC",
        "first_name": "NICHOLAS",
        "middle_name": "E",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-11",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT6516",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096002615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John D Gorman
• Christopher Joseph Gough, LCPC
• Haley Ranae Goulson, PA-C
• Kristen Elizabeth Govig, APRN, CNP
• Andrea Graham
• Paul Grasemann
• Robert Kurt Gratschmayr, OTR/L
• Jade Gray
• Greater Family Health
• Greater Family Health

• Athletic Trainer in Dekalb, IL
• Providers in Dekalb, IL by specialty
• Athletic Trainer in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; 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.