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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