# PROREHAB, PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** ATHLETICO PHYSICAL THERAPY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194778183
- **Authorized official:** JUANA L GRANADOS (CREDENTIALING MANAGER)
- **Authorized official phone:** (630) 575-1980

## Contact information

- **Practice address:** 3726 S KINGSHIGHWAY BLVD, SAINT LOUIS, MO 63109-1800
- **Practice address phone:** (314) 351-7172
- **Practice address fax:** (314) 351-6885
- **Mailing address:** 600 OAKMONT LN STE 600C, WESTMONT, IL 60559-5548
- **Mailing address phone:** (630) 575-1980
- **Mailing address fax:** (630) 928-5080

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/18/2006
- **Last updated:** 01/17/2020