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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 Therapist060005437IL

General Provider Information

NPI Number : 1629371349
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 : 630-575-1940
Fax Number : 630-928-5040
Provider Business Practice Location Address
First Line : 1733 N RICHMOND RD
Second Line :
City : MCHENRY
State : IL
Zip : 60051-5413
Country : US
Telephone Number : 815-385-0730
Fax Number : 815-385-0572
Authorized Official
Title or Position : DIRECTOR OF CLINICAL SERVICES
Name : GERI COOK
Credential :
Telephone Number : 630-575-1940
Provider Enumeration Date : 12/20/2010
Last Update Date : 10/07/2016

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Directions to “ATHLETICO, LTD ” Practice Location

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