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Organization
ATHLETICO LTD
Active
Organization
ATHLETICO LTD
Active
Other names
Athletico Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
JUANA GRANADOS (CREDENTIALING MANAGER)
(630) 575-1980
Entity
Organization
Contact information
Practice address
12551 STATE ROUTE 143 STE F, HIGHLAND, IL 62249-1192
(618) 701-9711
(618) 882-7001
Mailing address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
(630) 575-1980
(630) 928-5080
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
NULL
225X00000X
Occupational Therapist
—
—
261Q00000X
Clinic/Center
Primary
—
NULL
Other
Enumeration date
10/29/2021
Last updated
10/29/2021
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