Healthcare Provider Details

I. General information

NPI: 1356500193
Provider Name (Legal Business Name): ATI HOLDINGS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2008
Last Update Date: 02/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 BEISER BLVD SUITE 102
DOVER DE
19904-7790
US

IV. Provider business mailing address

790 REMINGTON BLVD
BOLINGBROOK IL
60440-4909
US

V. Phone/Fax

Practice location:
  • Phone: 302-741-0200
  • Fax: 302-741-0245
Mailing address:
  • Phone: 630-296-2222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: LYNN MCGIVERN
Title or Position: CHIEF COMPLIANCE OFFICER
Credential:
Phone: 630-296-2222