Organization
ATHLETICO LTD
Active
Other names
Athletico Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JUANA L GRANADOS (CREDENTIALING MANAGER)
(630) 575-1980
Entity
Organization
Contact information
Practice address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
(630) 575-1980
(630) 928-5080
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
—
IL
261Q00000X
Clinic/Center
Primary
—
—
261QR0400X
Rehabilitation Clinic/Center
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001618843
BLUE CROSS BLUE SHIELD
IL
Enumeration date
10/03/2005
Last updated
08/11/2026
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