NPIMap

Organization Active NPI

Athletico LTD

Doing business as Athleico Physical Therapy

  • Clinic/Center
  • Saint John, IN
National Provider Identifier
1306493507
Registry record updated Aug 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
ATHLETICO LTD
Doing business as
Athleico Physical Therapy
Athletico Physical Therapy
Practice address
10081 Wicker Ave #4
Saint John, IN 46373
Phone
(219) 627-6445
Fax
(219) 351-1803
NPI assigned
Aug 22, 2019
Last updated
Aug 28, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2019

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

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary
Physical Therapist 225100000X NU
Occupational Therapist 225X00000X NU

Addresses

Primary practice location

10081 Wicker Ave #4
Saint John, IN 46373

Mailing address

600 Oakmont LN Ste 600C
Westmont, IL 60559-5548
Phone (630) 575-6250

Other names 2

  • Athleico Physical Therapy Doing business as
  • Athletico Physical Therapy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Accelerated Rehab Assoc159 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566950400000",
    "number": "1306493507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 OAKMONT LN STE 600C",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595548",
            "telephone_number": "630-575-6250",
            "fax_number": "630-575-7450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10081 WICKER AVE #4",
            "city": "SAINT JOHN",
            "state": "IN",
            "postal_code": "46373",
            "telephone_number": "219-627-6445",
            "fax_number": "219-351-1803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHLETICO LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-22",
        "last_updated": "2019-08-28",
        "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": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Athleico Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Athletico Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint John, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; 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.