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