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Organization

ATHLETIC & THERAPEUTIC INSTITUTE OF BOURBONNAIS, LLC

Active
Other names
ATI Physical Therapy, ATI of Minooka
Organization subpart
No

Provider details

NPI number
Authorized official
WADE A MEYER (CHIEF COMPLIANCE OFFICER)
(630) 296-2223
Entity
Organization

Contact information

Practice address
2081 RIDGE RD, SUITE101, MINOOKA, IL 60447-8848
(815) 467-1612
(815) 467-1866
Mailing address
2001 BUTTERFIELD RD STE 1600, DOWNERS GROVE, IL 60515-1211
(630) 296-2223

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
610128402
DEPT OF LABOR
IL
01
DR5855
MEDICARE RAILROAD
IL
Enumeration date
03/05/2010
Last updated
03/24/2026
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