NPIMap

Organization Active NPI

Athletic & Therapeutic Institute of Bourbonnais, LLC

Doing business as ATI Physical Therapy

  • Physical Therapist
  • Minooka, IL
National Provider Identifier
1083937056
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ATHLETIC & THERAPEUTIC INSTITUTE OF BOURBONNAIS, LLC
Doing business as
ATI Physical Therapy
Practice address
2081 Ridge Rd
Suite101
Minooka, IL 60447-8848
Phone
(815) 467-1612
Fax
(815) 467-1866
NPI assigned
Mar 5, 2010
Last updated
Mar 24, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Wade A MeyerNPI 1396837498
Title
Chief Compliance Officer
Phone
(630) 296-2223

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X IL Primary

Addresses

Primary practice location

2081 Ridge Rd
Suite101
Minooka, IL 60447-8848

Mailing address

2001 Butterfield Rd Ste 1600
Downers Grove, IL 60515-1211
Phone (630) 296-2223

Other identifiers 2

IdentifierTypeStateIssuer
610128402OtherILDEPT OF LABOR
DR5855OtherILMEDICARE RAILROAD

Other names 2

  • ATI Physical Therapy Doing business as
  • ATI of Minooka Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040923000220 IL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4183692577 Receives reassigned benefits from 405 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Athletic and Therapeutic Institute of Bourbonnais LLC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2320 W Jefferson St
Ste 2324
Joliet, IL 60435
Phone (815) 741-3758

3082 Caton Farm Rd
Joliet, IL 60435
Phone (630) 783-2001

1419 W Lane Rd
Ste C
Machesney Park, IL 61115
Phone (815) 997-1350

Practitioners & affiliated clinicians

Practitioners 59

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 59

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1267747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774310400000",
    "number": "1083937056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211",
            "telephone_number": "630-296-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2081 RIDGE RD",
            "address_2": "SUITE101",
            "city": "MINOOKA",
            "state": "IL",
            "postal_code": "604478848",
            "telephone_number": "815-467-1612",
            "fax_number": "815-467-1866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHLETIC & THERAPEUTIC INSTITUTE OF BOURBONNAIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-05",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "WADE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "630-296-2223"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "610128402",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DR5855",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ATI Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ATI of Minooka",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Minooka, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.