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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
1225X00000XOccupational Therapist
2225100000XPhysical Therapist
3261Q00000XClinic/Center

General Provider Information

NPI Number : 1871247841
Entity Type Code : Organization
Provider Name (Legal Business Name) : ATHLETICO LTD
Provider Business Mailing Address
First Line : 2122 YORK RD STE 300
Second Line :
City : OAK BROOK
State : IL
Zip : 60523-1925
Country : US
Telephone Number : 630-575-6250
Fax Number : 630-575-7450
Provider Business Practice Location Address
First Line : 3131 CUSTER RD STE 100
Second Line :
City : PLANO
State : TX
Zip : 75075-2083
Country : US
Telephone Number : 214-427-1541
Fax Number : 214-817-4052
Authorized Official
Title or Position : CREDENTIALING MANAGER
Name : JUANA GRANADOS
Credential :
Telephone Number : 630-575-1980
Provider Enumeration Date : 02/09/2022
Last Update Date : 02/09/2022

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Directions to “ATHLETICO LTD ” Practice Location

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