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NPI Code Detail

MEDICARE: ATI HOLDING LLC

MEDICARE: ATI HOLDING LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist
2225100000XPhysical Therapist

General Provider Information

NPI Number : 1568947380
Entity Type Code : Organization
Provider Name (Legal Business Name) : ATI HOLDING LLC
Provider Business Mailing Address
First Line : 790 REMINGTON BLVD
Second Line :
City : BOLINGBROOK
State : IL
Zip : 60440-4909
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8116 RITCHIE HWY
Second Line :
City : PASADENA
State : MD
Zip : 21122-6916
Country : US
Telephone Number : 443-261-2220
Fax Number :
Authorized Official
Title or Position : CCO
Name : LYNN MCGIVERN
Credential :
Telephone Number : 630-296-2222
Provider Enumeration Date : 09/27/2018
Last Update Date : 09/27/2018

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Directions to “ATI HOLDING LLC ” Practice Location

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