NPIMap

Organization Active NPI

Athletic and Therapeutic Institute of Bourbonnais, LLC

  • Durable Medical Equipment & Medical Supplies
  • Columbia, IL
National Provider Identifier
1124766696
Registry record updated Dec 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
ATHLETIC AND THERAPEUTIC INSTITUTE OF BOURBONNAIS, LLC
Practice address
1000 Eleven S Ste 1B
Columbia, IL 62236-1078
Phone
(618) 281-9699
NPI assigned
May 25, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2025

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

Authorized official

Name
Wade A Meyer
Title
VP Chief Compliance Officer
Phone
(630) 296-2222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

1000 Eleven S Ste 1B
Columbia, IL 62236-1078

Mailing address

2001 Butterfield Rd Ste 1600
Downers Grove, IL 60515-1211

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220713003556 IL DME Supplier - Independently-Practicing Physical TherapistDME Supplier - Independently-Practicing Occupational Therapist 4183692577 Practice locations: Columbia, IL

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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.

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

27 S Western Ave
Ste B
Carpentersville, IL 60110
Phone (224) 293-1200

1071 Collinsville Crossing Blvd
Ste 1073
Collinsville, IL 62234
Phone (618) 301-3012

1000 Eleven S
Ste 1B
Columbia, IL 62236
Phone (618) 281-9699

5005 N West Hwy
Ste 105
Crystal Lake, IL 60014
Phone (779) 220-5150

2121 Sycamore Rd
DeKalb, IL 60115
Phone (630) 355-5255

1015 Commerce Dr
Fairfield, IL 62837
Phone (618) 847-0205

934 Il Route 22
Fox River Grove, IL 60021
Phone (847) 462-6108

3000 W Jefferson St
Joliet, IL 60435
Phone (815) 553-2340

1312 Houbolt Rd
Joliet, IL 60431
Phone (815) 553-2860

1521 E Riverside Blvd
Ste 2
Loves Park, IL 61111
Phone (815) 668-4797

327 W Washington St
Millstadt, IL 62260
Phone (618) 476-9444

13327 S Route 59
Unit 103
Plainfield, IL 60585
Phone (815) 609-0570

23915 W Main St
Ste B
Plainfield, IL 60544
Phone (815) 609-0570

23915 W Main St
Unit 105
Plainfield, IL 60544
Phone (815) 577-8844

23915 W Main St
Ste 107109
Plainfield, IL 60544
Phone (815) 609-0570

804 State St
Unit 5
Quincy, IL 62301
Phone (217) 224-1750

724 E Rollins Rd
Round Lake Beach, IL 60073
Phone (847) 270-8028

972 Brook Forest Ave
Shorewood, IL 60404
Phone (815) 439-4938

2308 Wabash Ave
Springfield, IL 62704
Phone (217) 241-0380

180 Waterloo Commons Dr
Waterloo, IL 62298
Phone (618) 939-5555

Practitioners & affiliated clinicians

Practitioners 426

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 426

NPI Registry JSON

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

{
    "created_epoch": "1653436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767139200000",
    "number": "1124766696",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 ELEVEN S STE 1B",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "622361078",
            "telephone_number": "618-281-9699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHLETIC AND THERAPEUTIC INSTITUTE OF BOURBONNAIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-25",
        "last_updated": "2025-12-31",
        "certification_date": "2025-12-31",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "WADE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VP CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "630-296-2222"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2025; 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.