Healthcare Provider Details

I. General information

NPI: 1992916969
Provider Name (Legal Business Name): ATA HEALTH SYSTEMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 N HARBOR DR SUITE 3906
CHICAGO IL
60601-7344
US

IV. Provider business mailing address

175 N HARBOR DR SUITE 3906
CHICAGO IL
60601-7344
US

V. Phone/Fax

Practice location:
  • Phone: 773-978-2100
  • Fax: 773-978-1568
Mailing address:
  • Phone: 773-978-2100
  • Fax: 773-978-1568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. PETER AKERELE
Title or Position: PRESIDENT
Credential: DPM
Phone: 773-978-2100