Organization Active NPI

Athletic &Therapeutic Institute of Bourbonnais LLC

Doing business as ATI Physical Therapy

  • Durable Medical Equipment & Medical Supplies
  • Bourbonnais, IL
National Provider Identifier
1952951808
Registry record updated Sep 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
ATHLETIC &THERAPEUTIC INSTITUTE OF BOURBONNAIS LLC
Doing business as
ATI Physical Therapy
Practice address
1275 N Convent St Ste 3
Bourbonnais, IL 60914-8211
Phone
(815) 936-1855
Fax
(815) 936-6097
NPI assigned
Sep 12, 2019
Last updated
Sep 12, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2019

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

Authorized official

Name
Wade Meyer, COONPI 1396837498
Title
Coo
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
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

1275 N Convent St Ste 3
Bourbonnais, IL 60914-8211

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2222

Other names 1

  • ATI Physical Therapy Doing business as

National Provider Directory

National Provider Directory

Member of 2

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

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1568246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568246400000",
    "number": "1952951808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 N CONVENT ST STE 3",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609148211",
            "telephone_number": "815-936-1855",
            "fax_number": "815-936-6097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHLETIC &THERAPEUTIC INSTITUTE OF BOURBONNAIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-12",
        "last_updated": "2019-09-12",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "WADE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "630-296-2223",
        "authorized_official_credential": "COO"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ATI Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bourbonnais, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.