Organization
ATHLETIC & THERAPEUTIC INSTITUTE OF BOURBONNAIS, LLC
Active
Other names
ATI PT
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN MCGIVERN (CCO)
(630) 296-2222
Entity
Organization
Contact information
Practice address
110 MOONEY DR, SUITE 5, BOURBONNAIS, IL 60914-2171
(815) 936-0611
(815) 936-0564
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629397401
—
IL
Enumeration date
05/19/2010
Last updated
02/18/2022
Update your record
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