Organization
ATHLETIC AND THERAPEUTIC INSTITUTE OF MILWAUKEE, LLC
Active
Other names
ATI Active Care
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN MCGIVERN (CHIEF COMPLIANCE OFFICER)
(630) 296-2222
Entity
Organization
Contact information
Practice address
2835 N GRANDVIEW BLVD, STE 100, PEWAUKEE, WI 53072-5546
(262) 262-1100
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/13/2014
Last updated
01/13/2014
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