Healthcare Provider Details

I. General information

NPI: 1356545420
Provider Name (Legal Business Name): ATHLETICO LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2007
Last Update Date: 08/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 SEDGE BLVD
HOFFMAN ESTATES IL
60192-3712
US

IV. Provider business mailing address

5050 SEDGE BLVD
HOFFMAN ESTATES IL
60192-3712
US

V. Phone/Fax

Practice location:
  • Phone: 847-645-9673
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: GERI COOK
Title or Position: DIRECTOR OF CLINICAL SERVICES
Credential:
Phone: 630-575-1940