Organization
ATHLETIC AND THERAPEUTIC INSTITUTE OF NAPERVILLE LLC
Active
Other names
ATI of Carol Stream Wheaton, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MARK BOGOVICH (CFO)
(630) 296-2222
Entity
Organization
Contact information
Practice address
327 GUNDERSEN DR, SUITE C, CAROL STREAM, IL 60188-2402
(630) 784-3251
(630) 665-8188
Mailing address
4947 PAYSPHERE CIR, CHICAGO, IL 60674-0049
(630) 783-2001
(630) 783-0117
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
356148903
DEPARTMENT OF LABOR PROVIDER NUMBER
IL
Enumeration date
04/24/2007
Last updated
03/04/2009
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