Athletic & Therapeutic Institute of Naperville, LLC
Organization Active NPI Physical Therapist · Geneva, IL
NPI 1831387943 · NPPES record last updated Mar 4, 2009
Key facts
- NPI
- 1831387943
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- ATHLETIC & THERAPEUTIC INSTITUTE OF NAPERVILLE, LLC
- Practice address
- 1002 Commons Dr
Suite 1002
Geneva, IL 60134-2539 - Phone
- (630) 208-7831
- Fax
- (630) 208-9033
- NPI assigned
- Oct 15, 2007
- Organization subpart
- No
Authorized official
- Name
- Mark Bogovich
- Title
- Cfo
- Phone
- (630) 296-2222
Corporate family (same tax ID) 11
Practitioners 5
-
Amy Billo, DPT
-
Douglas Bradley, PT, CSCS
-
Ann Choi, DPT
-
Emily Lira, DPT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Tax ID family
- Ati Holdings LLC
Locations
4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes |
Addresses
Primary practice location
1002 Commons Dr
Suite 1002
Geneva, IL 60134-2539
Mailing address
4947 Paysphere Cir
Chicago, IL 60674-0049
Phone (630) 783-2001
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 356148904 | Other | IL | DEPARTMENT OF LABOR PROVIDER NUMBER |
Other names
- ATI Physical Therapy
NPI Registry JSON
{
"created_epoch": "1192406400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1236124800000",
"number": "1831387943",
"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": "1002 COMMONS DR",
"address_2": "SUITE 1002",
"city": "GENEVA",
"state": "IL",
"postal_code": "601342539",
"telephone_number": "630-208-7831",
"fax_number": "630-208-9033"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ATHLETIC & THERAPEUTIC INSTITUTE OF NAPERVILLE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-10-15",
"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 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": "356148904",
"state": "IL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "ATI Physical Therapy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Geneva, IL
- Luke Arnfelt
- Ashley Arnold
- Amy Lynn Arrocena
- Art of Reflection PC
- Athletic & Therapeutic Institute of Bourbonnais LLC
- Athletic and Therapeutic Institute of Naperville, LLC
- Jessica Marie Atkins
- Meera Kataria Atkins
- Thomas A Atkins
- Brent Joseph Atkinson
All providers in Geneva, IL · Physical Therapist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.