Provider Demographics
NPI:1366699910
Name:ATIC ONE S.C.
Entity type:Organization
Organization Name:ATIC ONE S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VIKAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BHATARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-922-3300
Mailing Address - Street 1:17577 KEDZIE AVE
Mailing Address - Street 2:SUITE #105
Mailing Address - City:HAZEL CREST
Mailing Address - State:IL
Mailing Address - Zip Code:60429-2051
Mailing Address - Country:US
Mailing Address - Phone:708-922-3300
Mailing Address - Fax:708-794-4151
Practice Address - Street 1:17577 KEDZIE AVE
Practice Address - Street 2:SUITE #105
Practice Address - City:HAZEL CREST
Practice Address - State:IL
Practice Address - Zip Code:60429-2051
Practice Address - Country:US
Practice Address - Phone:708-922-3300
Practice Address - Fax:708-794-4151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036116058261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care