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NPI Code Detail

MEDICARE: MRS. RITA DENISE ATOR PT ATC

MEDICARE:  MRS. RITA DENISE ATOR  PT ATC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12255A2300XAthletic Trainer096000275IL
2225100000XPhysical Therapist30477AZ
3225100000XPhysical Therapist070005288IL

General Provider Information

NPI Number : 1205893682
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. RITA DENISE ATOR PT ATC
Provider Business Mailing Address
First Line : 790 REMINGTON BLVD
Second Line :
City : BOLINGBROOK
State : IL
Zip : 60440-4909
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2005 W HAPPY VALLEY RD STE 170
Second Line :
City : PHOENIX
State : AZ
Zip : 85085-2898
Country : US
Telephone Number : 623-322-0654
Fax Number : 623-322-0664
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2006
Last Update Date : 12/16/2022

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Directions to “ MRS. RITA DENISE ATOR PT ATC” Practice Location

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