Organization
ATHLETICO LTD
Active
Other names
Athletico Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
JUANA GRANADOS (CREDENTIALING DIRECTOR)
(630) 575-1980
Entity
Organization
Contact information
Practice address
1442 BRUSH ST, 1ST FLOOR, DETROIT, MI 48226-2285
(313) 334-4302
(313) 307-0099
Mailing address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
(630) 575-6200
(630) 928-5080
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
01/14/2019
Last updated
02/19/2026
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