Healthcare Provider Details

I. General information

NPI: 1366710584
Provider Name (Legal Business Name): ATHLETIC & THERAPEUTIC INSTITUTE OF MILWAUKEE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2011
Last Update Date: 02/10/2026
Certification Date: 02/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5502 WASHINGTON AVE SUITE 500
MOUNT PLEASANT WI
53406-4093
US

IV. Provider business mailing address

2001 BUTTERFIELD RD STE 1600
DOWNERS GROVE IL
60515-1211
US

V. Phone/Fax

Practice location:
  • Phone: 262-637-2470
  • Fax: 262-637-2532
Mailing address:
  • Phone: 630-296-2222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: WADE A MEYER
Title or Position: CHIEF COMPLIANCE OFFICER
Credential:
Phone: 630-296-2223