Athletico LTD

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

ATHLETICO LTD

Practice address

43443 Grand River Ave
Suite 200
Novi, MI 48375-1106

Phone

(248) 305-9200

Fax

(248) 305-9330

NPI assigned

May 17, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Juana Granados

Title

Credentialing Manager

Phone

(630) 575-1980

Specialties & licenses 3

Addresses

Other names 1

• Athletico Physical Therapy Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Athletico LTD

  • Physical Therapist
  • Oak Brook, IL
  • NPI 1427264233

  Member Of

  NPD member

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1463443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581379200000",
    "number": "1174970404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 ENTERPRISE DR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238813",
            "telephone_number": "630-575-1932",
            "fax_number": "630-928-5032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43443 GRAND RIVER AVE",
            "address_2": "SUITE 200",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751106",
            "telephone_number": "248-305-9200",
            "fax_number": "248-305-9330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHLETICO LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-17",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A",
        "authorized_official_last_name": "GRANADOS",
        "authorized_official_first_name": "JUANA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "630-575-1980"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Athletico Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Athletico Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bushra Atalla
• John Atallah, LMSW - C
• Vida Atchulo-Gomnah
• Myles Aten
• Valerie A Athan
• Linda Atkinson
• Nadine Atoui, DNP
• Anshika Atri
• Attendant Special Care
• Yasmine Attie

• Clinic/Center in Novi, MI
• Providers in Novi, MI by specialty
• Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.