NPIMap

Organization Active NPI

Athletic and Therapeutic Institute of Bourbonnais, LLC

Doing business as ATI Physical Therapy

  • Durable Medical Equipment & Medical Supplies
  • Joliet, IL
National Provider Identifier
1417440736
Registry record updated Nov 20, 2024
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
Doing business as
ATI Physical Therapy
Practice address
3082 Caton Farm Rd
Joliet, IL 60435-1455
Phone
(815) 577-9936
NPI assigned
Jun 11, 2018
Last updated
Nov 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

3082 Caton Farm Rd
Joliet, IL 60435-1455

Mailing address

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

Other names 1

  • ATI Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180717000521 IL DME Supplier - Independently-Practicing Physical TherapistDME Supplier - Independently-Practicing Occupational Therapist 4183692577 Practice locations: Joliet, 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.

NPI Registry JSON

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732060800000",
    "number": "1417440736",
    "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": "3082 CATON FARM RD",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604351455",
            "telephone_number": "815-577-9936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHLETIC AND THERAPEUTIC INSTITUTE OF BOURBONNAIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-11",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "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": [
        {
            "organization_name": "ATI Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.