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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 Therapist

General Provider Information

NPI Number : 1629284450
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 : 4080 N MILWAUKEE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60641-1831
Country : US
Telephone Number : 773-545-1153
Fax Number :
Authorized Official
Title or Position : DIRECTOR OF CLINICAL SERVICES
Name : GERI COOK
Credential :
Telephone Number : 630-575-1940
Provider Enumeration Date : 05/16/2007
Last Update Date : 08/22/2017

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Directions to “ATHLETICO LTD ” Practice Location

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