0000899243-21-046419.txt : 20211201 0000899243-21-046419.hdr.sgml : 20211201 20211201164506 ACCESSION NUMBER: 0000899243-21-046419 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211130 FILED AS OF DATE: 20211201 DATE AS OF CHANGE: 20211201 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LARSEN JOHN L CENTRAL INDEX KEY: 0001065871 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39439 FILM NUMBER: 211463560 MAIL ADDRESS: STREET 1: C/O ATI PHYSICAL THERAPY STREET 2: 790 REMINGTON BLVD. CITY: BOLINGBROOK STATE: IL ZIP: 60440-4909 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ATI Physical Therapy, Inc. CENTRAL INDEX KEY: 0001815849 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-NURSING & PERSONAL CARE FACILITIES [8050] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 790 REMINGTON BOULEVARD CITY: BOILINGBROOK STATE: IL ZIP: 60440 BUSINESS PHONE: 702-844-6111 MAIL ADDRESS: STREET 1: 790 REMINGTON BOULEVARD CITY: BOILINGBROOK STATE: IL ZIP: 60440 FORMER COMPANY: FORMER CONFORMED NAME: Fortress Value Acquisition Corp. II DATE OF NAME CHANGE: 20200622 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-11-30 0 0001815849 ATI Physical Therapy, Inc. ATIP 0001065871 LARSEN JOHN L C/O ATI PHYSICAL THERAPY 790 REMINGTON BOULEVARD BOLINGBROOK IL 60440 1 1 0 0 Executive Chairman Class A common stock 2021-11-30 4 P 0 10000 3.63 A 98450 D /s/ Erik Kantz, as Attorney-In-Fact for Reporting Person 2021-12-01