Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Vidit Atul Phanse

Individual provider Physical Therapist · NPI 1043731540

Vidit Atul Phanse is a Physical Therapist in Private Practice in Lockport, Illinois. Qualified in 2015, 11 years ago. Practices with Athletic and Therapeutic Institute of Bourbonnais, LLC, a 170-clinician group and accepts Medicare assignment. Licensed in Illinois and North Carolina.

Years since qualifying
11
Licensed in
IL, NC
In the registry since
2017
Specialties on file
2
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Practice location Address checks out

1065 E 9th St
Lockport, IL 60441-3567
Phone: (815) 588-1366
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 070022922 (IL)
Physical Therapist Taxonomy 225100000X · Licence P23372 (NC)

Record details

NPI number1043731540
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 5, 2017
Last updated in NPPESMarch 6, 2026
Certification dateMarch 6, 2026
Mailing address790 Remington Blvd, Bolingbrook, IL 60440-4909

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Athletic And Therapeutic Institute Of Bourbonnais, Llc — 170 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Lockport