Active NPI
Athletico LTD
Doing business as Athletico Physical Therapy
- Clinic/Center
- Dearborn, MI
National Provider Identifier
1467027607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- Legal business name
- ATHLETICO LTD
- Doing business as
- Athletico Physical Therapy
- Practice address
- 22435 Michigan Ave
Dearborn, MI 48124-2130 - Phone
- (313) 637-9599
- Fax
- (313) 771-9836
- NPI assigned
- May 20, 2021
- Last updated
- May 20, 2021
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | NU | Primary | |
| Physical Therapist | 225100000X | NU | ||
| Occupational Therapist | 225X00000X | NU |
Addresses
Primary practice location
22435 Michigan Ave
Dearborn, MI 48124-2130
Mailing address
2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-6200
Other names 1
- Athletico Physical Therapy
National Provider Directory
National Provider Directory- Tax ID family
- Athletico Physical Therapy
Organizations with this tax ID in the same state 19
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- Clinic/Center
- Van Buren TWP, MI
- NPI 1265158091
-
- Clinic/Center
- Hartland, MI
- NPI 1275230104
-
dba Accelerated Rehabilitation Centers, Ltd
- Clinic/Center
- Temperance, MI
- NPI 1336522457
-
- Clinic/Center
- Grosse Pointe Woods, MI
- NPI 1477229318
Locations
22435 Michigan Ave
Dearborn, MI 48124
Phone (313) 637-9599
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621468800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1621468800000",
"number": "1467027607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2122 YORK RD STE 300",
"city": "OAK BROOK",
"state": "IL",
"postal_code": "605231925",
"telephone_number": "630-575-6200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22435 MICHIGAN AVE",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481242130",
"telephone_number": "313-637-9599",
"fax_number": "313-771-9836"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ATHLETICO LTD",
"organizational_subpart": "NO",
"enumeration_date": "2021-05-20",
"last_updated": "2021-05-20",
"certification_date": "2021-05-20",
"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": "Athletico Physical Therapy",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.