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NPI Code Detail

MEDICARE: ATHLETIC AND THERAPEUTIC INSTITUTE OF NAPERVILLE, LLC

MEDICARE: ATHLETIC AND THERAPEUTIC INSTITUTE OF NAPERVILLE, LLC
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
1225100000XPhysical TherapistIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1610078608OTHERILDEPT OF LABOR

General Provider Information

NPI Number : 1942532932
Entity Type Code : Organization
Provider Name (Legal Business Name) : ATHLETIC AND THERAPEUTIC INSTITUTE OF NAPERVILLE, LLC
Provider Business Mailing Address
First Line : 790 REMINGTON BLVD
Second Line :
City : BOLINGBROOK
State : IL
Zip : 60440-4909
Country : US
Telephone Number : 630-296-2222
Fax Number :
Provider Business Practice Location Address
First Line : 1226 S CANAL ST
Second Line :
City : CHICAGO
State : IL
Zip : 60607-5213
Country : US
Telephone Number : 312-733-8958
Fax Number : 312-733-9447
Authorized Official
Title or Position : CHIEF COMPLIANCE OFFICER
Name : LYNN MCGIVERN
Credential :
Telephone Number : 630-296-2222
Provider Enumeration Date : 02/02/2010
Last Update Date : 04/07/2011

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Directions to “ATHLETIC AND THERAPEUTIC INSTITUTE OF NAPERVILLE, LLC ” Practice Location

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