Organization
PERFORMANCE REHABILITATION OF WESTERN NEW ENGLAND LLC
Active
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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