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Organization
ACCELERATED REHABILITATION CENTER OF KENOSHA LTD
Active
Organization
ACCELERATED REHABILITATION CENTER OF KENOSHA LTD
Active
Other names
ATHLETICO PHYSICAL THERAPY
Organization subpart
No
Provider details
NPI number
Authorized official
GERI COOK (DIRECTOR OF CLINICAL SERVICES)
(630) 575-1940
Entity
Organization
Contact information
Practice address
625 ENTERPRISE DR, OAK BROOK, IL 60523-8813
(630) 575-6200
(630) 928-5080
Mailing address
625 ENTERPRISE DR, OAK BROOK, IL 60523-8813
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NULL
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
NULL
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6726070001
DMERC
IL
01
—
6726070002
DMERC
IL
01
—
IL6237
MEDICARE
IL
01
—
IL6238
MEDICARE
IL
01
—
IL6697
MEDICARE
IL
Enumeration date
06/24/2011
Last updated
04/12/2016
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