Provider Demographics
NPI:1013109099
Name:ATI HOLDINGS, LLC
Entity Type:Organization
Organization Name:ATI HOLDINGS, LLC
Other - Org Name:ATI PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGIVERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-296-2222
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:630-296-2222
Mailing Address - Fax:
Practice Address - Street 1:1510 ROCK SPRING RD
Practice Address - Street 2:STE C
Practice Address - City:FOREST HILL
Practice Address - State:MD
Practice Address - Zip Code:21050-2851
Practice Address - Country:US
Practice Address - Phone:410-420-3619
Practice Address - Fax:410-420-3620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-14
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000040229Medicaid
DE1000040229Medicaid
DEG02378Medicare PIN