Organization
ATHLETICO LTD
Active
Other names
Atheltico Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
JUANA GRANADOS (DIRECTOR, CREDENTIALING)
(630) 575-1980
Entity
Organization
Contact information
Practice address
2615 N DOWNER AVE, MILWAUKEE, WI 53211-4245
(414) 962-4400
(414) 662-5674
Mailing address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
(630) 575-6200
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WI1760
MEDICARE PTAN
WI
Enumeration date
10/23/2009
Last updated
04/17/2026
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