# ATHLETICO LTD

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Atheltico Physical Therapy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083940274
- **Authorized official:** JUANA GRANADOS (DIRECTOR, CREDENTIALING)
- **Authorized official phone:** (630) 575-1980

## Contact information

- **Practice address:** 2615 N DOWNER AVE, MILWAUKEE, WI 53211-4245
- **Practice address phone:** (414) 962-4400
- **Practice address fax:** (414) 662-5674
- **Mailing address:** 2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
- **Mailing address phone:** (630) 575-6200

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/23/2009
- **Last updated:** 04/17/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | WI1760 | MEDICARE PTAN | WI |