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General NPI Number Information
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NPI Number | 1144331794
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Entity Type | Organization
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Legal Business Name | ATHLETIC AND THERAPEUTIC INSTITUTE OF NAPERVILLE, LLC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 04/07/2011
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Provider Practice Location Address
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Address Line | 7191 S KINGERY HWY SUITE L6
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City | WILLOWBROOK
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State | IL
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Zip | 60527-5525
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Country | US
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Telephone | 630-455-6630
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Fax | 630-455-6631
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Provider Business Mailing Address
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Address Line | 4947 PAYSPHERE CIR
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City | CHICAGO
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State | IL
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Zip | 60674-0049
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Country | US
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Telephone | 630-296-2223
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Fax | 630-759-6106
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Authorized Official
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Title or Position | CHIEF COMPLIANCE OFFICER
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Name | LYNN MCGIVERN
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Credential |
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Telephone | 630-296-2222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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