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NPI Code Detail

MEDICARE: ATHLETICO, LTD

MEDICARE: ATHLETICO, LTD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistIL

General Provider Information

NPI Number : 1598907669
Entity Type Code : Organization
Provider Name (Legal Business Name) : ATHLETICO, LTD
Provider Business Mailing Address
First Line : 625 ENTERPRISE DR.
Second Line :
City : OAK BROOK
State : IL
Zip : 60523-8813
Country : US
Telephone Number : 630-575-6250
Fax Number : 630-575-7450
Provider Business Practice Location Address
First Line : 1644 E 53RD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60615-4210
Country : US
Telephone Number : 773-241-6450
Fax Number : 773-241-6501
Authorized Official
Title or Position : DIRECTOR OF CLINICAL SERVICES
Name : GERI COOK
Credential :
Telephone Number : 630-575-1940
Provider Enumeration Date : 04/03/2009
Last Update Date : 08/22/2017

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Directions to “ATHLETICO, LTD ” Practice Location

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