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Organization

ATHLETIC AND THERAPEUTIC INSTITUTE OF BOURBONNAIS, LLC

Active
Other names
ATI Physical Therapy
Organization subpart
No

Provider details

NPI number
Authorized official
WADE A MEYER (VP CHIEF COMPLIANCE OFFICER)
(630) 296-2222
Entity
Organization

Contact information

Practice address
1275 N CONVENT ST, SUITE 3, BOURBONNAIS, IL 60914-8210
(815) 936-1855
(815) 936-6097
Mailing address
2001 BUTTERFIELD RD STE 1600, DOWNERS GROVE, IL 60515-1211
(630) 296-2222

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04632047
BLUE CROSS BLUE SHIELD
IL
01
610128400
DEPARTMENT OF LABOR PROVIDER NUMBER
IL
01
7725634
AETNA
IL
Enumeration date
08/31/2006
Last updated
03/24/2026
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