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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 : 1750813002
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 : 557 S STATE ST
Second Line :
City : CHICAGO
State : IL
Zip : 60605-1616
Country : US
Telephone Number : 312-361-0261
Fax Number : 312-361-0262
Authorized Official
Title or Position : VP OF BILLING OPERATIONS
Name : GERI COOK
Credential :
Telephone Number : 630-575-1940
Provider Enumeration Date : 03/28/2017
Last Update Date : 03/28/2017

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Directions to “ATHLETICO, LTD. ” Practice Location

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