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Organization

PERFORMANCE REHABILITATION OF WESTERN NEW ENGLAND LLC

Active
Other names
ATI Physical Therapy of Western Massachusetts
Organization subpart
No

Provider details

NPI number
Authorized official
LYNN MCGIVERN (CHIEF COMPLIANCE OFFICER)
(630) 296-2223
Entity
Organization

Contact information

Practice address
70 POST OFFICE PARK, SUITE 7007, WILBRAHAM, MA 01095-1287
(413) 279-1435
(413) 279-1438
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2251H1200X
Hand Physical Therapist
225X00000X
Occupational Therapist
225XH1200X
Hand Occupational Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
103355100
DEPT OF LABOR
MA
01
28117
HEALTH NEW ENGLAND
MA
01
64-04290
UNITED HEALTHCARE
MA
01
9715568
TUFTS
MA
05
9715568
MA
01
972730
NETWORK HEALTH
MA
01
AA49027
HARVARD PILGRIM
MA
01
OG0011
OT----BLUE CROSS BLUE SHIELD
MA
01
Y61264
PT---BLUE CROSS BLUE SHIELD
MA
Enumeration date
10/12/2009
Last updated
06/08/2017
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