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
—
—
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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