MODERN ATHLETE PHYSICAL THERAPY LLC (NPI# 1346859477) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346859477 |
| Entity Type | Organization |
| Organization Name | MODERN ATHLETE PHYSICAL THERAPY LLC |
| Practice Address |
1033 Progress Dr Grayslake IL 60030-1672 |
| Mailing Address |
32 Lynn Dr Hawthorn Woods IL 60047-9102 |
| Practice Telephone | 8472575172 |
| Mailing Telephone | 8472575172 |
| Enumeration Date | 2020-07-24 |
| Last Update Date | 2020-07-24 |
| Authorized Official Name | MICHAEL TODD BITZER (OWNER, PHYSICAL THERAPIST) |
| Authorized Official Telephone | 8472575172 |
| Authorized Official Credential | PT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225700000X | Massage Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 2251S0007X |
Physical Therapist Specialization: Sports |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1033 PROGRESS DR |
| City | GRAYSLAKE |
| State | IL |
| Zip Code | 60030-1672 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396745675 | Michael Todd Bitzer | Physical Therapist | 1033 Progress Dr, Grayslake, IL 60030-1672 | 2005-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891393781 | Camelot Care Centers, LLC | Clinic/Center | 34121 North Route 45 Suite 207, Grayslake, IL 60030 | 2020-10-13 |
| 1992347892 | Pier London | Social Worker | 18640 Belivdere Rd., Grayslake, IL 60030 | 2019-10-11 |
| 1972156529 | Elizabeth Reeve | Counselor | 18640 Belvidere, Grayslake, IL 60030 | 2019-07-23 |
| 1144725987 | Michael Kraft | Family Medicine | 1475 E. Belvidere Road, Suite 385, Grayslake, IL 60030 | 2018-03-26 |
| 1255850780 | Megan B March | Speech-Language Pathologist | 33089 N Battershall Rd, Grayslake, IL 60030 | 2017-09-15 |
| 1669992665 | Easy Oxygen Inc. | Durable Medical Equipment & Medical Supplies | 1862 E Belvidere Road #125, Grayslake, IL 60030 | 2017-06-21 |
| 1184163628 | Surprenant Chiropractic LLC | Clinic/Center | 1227 N Illinois Route 83, Suite A, Grayslake, IL 60030 | 2017-02-16 |
| 1700230976 | Camelot Care Centers, LLC. | Foster Care Agency | 34121 North Route 45, Suite 207, Grayslake, IL 60030 | 2016-04-14 |
| 1932560414 | Vital Therapeutics Inc | Physical Therapist | 34121 N Us 45, Suite 101, Grayslake, IL 60030 | 2016-03-11 |
| 1093175804 | Zigma Visiting Physician, LLC | General Practice | 4 N Deer Point Dr, 1002, Hainesville, IL 60030 | 2016-03-07 |
| Find all providers in zip 60030 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437280195 | Rebecca H Ryan | Physical Therapist | 10 N Lake St, Suite 101, Grayslake, IL 60030-3635 | 2007-03-07 |
| 1396745675 | Michael Todd Bitzer | Physical Therapist | 1033 Progress Dr, Grayslake, IL 60030-1672 | 2005-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659986891 | Murtaza Aziz | Physical Therapist | 1431 N Western Ave Ste 140, Chicago, IL 60622-1770 | 2020-09-14 |
| 1902416720 | Epicore Physical Therapy | Physical Therapist | 1660 N La Salle Dr Apt 2708, Chicago, IL 60614-6021 | 2020-08-06 |
| 1356968374 | Genevieve Joy Owen | Physical Therapist | 555 Busse Hwy Unit C1, Park Ridge, IL 60068-3189 | 2020-06-26 |
| 1518597772 | Stability Physical Therapy and Wellness, LLC | Physical Therapist | 5031 W Balmoral Ave, Chicago, IL 60630-1507 | 2020-01-16 |
| 1154972719 | Antonio Marquez | Physical Therapist | 7425 Janes Ave Ste 200, Woodridge, IL 60517-2358 | 2019-09-25 |
| 1376198978 | Natalie N Ruebke | Physical Therapist | 251 Marketplace Dr # 2, Freeburg, IL 62243-4082 | 2019-08-09 |
| 1902360241 | Stephanie Lynne Burkhart | Physical Therapist | 12251 W 159th St, Homer Glen, IL 60491-7847 | 2019-01-30 |
| 1003388943 | Scoliosis Therapy Care and More LLC | Physical Therapist | 4n369 Booth Tarkington St, St Charles, IL 60175-7731 | 2018-12-17 |
| 1912478082 | Brandon Donnelly | Physical Therapist | 2200 Fort Jesse Rd Ste 230, Normal, IL 61761-6291 | 2018-12-16 |
| 1497251086 | John William Herbert | Physical Therapist | 1316 N Route 59, Naperville, IL 60563-4286 | 2018-04-03 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.