# ACCELERATED REHABILITATION CENTER OF KENOSHA LTD

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

## Provider details

- **NPI number:** 1649566951
- **Authorized official:** GERI COOK (DIRECTOR OF CLINICAL SERVICES)
- **Authorized official phone:** (630) 575-1940

## Contact information

- **Practice address:** 625 ENTERPRISE DR, OAK BROOK, IL 60523-8813
- **Practice address phone:** (630) 575-6200
- **Practice address fax:** (630) 928-5080
- **Mailing address:** 625 ENTERPRISE DR, OAK BROOK, IL 60523-8813

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |

## Other

- **Enumeration date:** 06/24/2011
- **Last updated:** 04/12/2016

## 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 |