MEDICARE: JAMIE SUPERAK 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
1	2255A2300X	Athletic Trainer
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1609262872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMIE SUPERAK ATC

Provider Business Mailing Address
First Line	:	9341 FRAMINGTON WAY
Second Line	:
City	:	ELK GROVE
State	:	CA
Zip	:	95758-4014
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9341 FRAMINGTON WAY
Second Line	:
City	:	ELK GROVE
State	:	CA
Zip	:	95758-4014
Country	:	US
Telephone Number	:	916-599-2317
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2015
Last Update Date	:	03/03/2025

Similar Medicare Providers

1003812777 — SERVICE MEDICAL EQUIPMENT, INC
Practice Location Address:

5017 CHASE AVE
DOWNERS GROVE, IL
60515-4014

Practice Phone: 888-848-1900
Practice Fax: 630-789-3375

1700119971 — MS. SUZANNE M LE BON RD, CNSC, CLC
Practice Location Address:

611 GRANITE ST
PACIFIC GROVE, CA
93950-4014

Practice Phone: 831-641-0576
Practice Fax:

1538779210 — KNJ HOLDINGS LLC
Practice Location Address:

4014 ARBOR GROVE TRL
MIDLOTHIAN, TX
76065-1788

Practice Phone: 702-808-6564
Practice Fax:

1467297309 — COMPLETE PHYSICAL THERAPY CENTER LLC
Practice Location Address:

5021 CHASE AVE
DOWNERS GROVE, IL
60515-4014

Practice Phone: 630-929-5377
Practice Fax: 630-929-0891

1922839430 — CAPTOR USA INC
Practice Location Address:

4014 PRAIRIE GROVE DR
RICHMOND, TX
77469-3920

Practice Phone: 201-456-3103
Practice Fax: 718-433-9002

1528899895 — DANIELLE E. YENTER PT
Practice Location Address:

5021 CHASE AVE
DOWNERS GROVE, IL
60515-4014

Practice Phone: 630-929-5377
Practice Fax:

Directions to “ JAMIE SUPERAK ATC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.