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NPI Code Detail

MEDICARE: ATI HOLDINGS, LLC

MEDICARE: ATI HOLDINGS, 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 : 1598147399
Entity Type Code : Organization
Provider Name (Legal Business Name) : ATI HOLDINGS, LLC
Provider Business Mailing Address
First Line : 790 REMINGTON BLVD
Second Line :
City : BOLINGBROOK
State : IL
Zip : 60440-4909
Country : US
Telephone Number : 630-296-2222
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 : 410-544-5376
Authorized Official
Title or Position : CHIEF COMPLIANCE OFFICER
Name : LYNN MCGIVERN
Credential :
Telephone Number : 630-296-2222
Provider Enumeration Date : 06/29/2015
Last Update Date : 06/29/2015

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