Active NPI
Athletico LTD
Doing business as Athletico Physical Therapy
- Clinic/Center
- Hamburg, MI
National Provider Identifier
1861942377
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
- 10020 Professional Center Drive
Hamburg, MI 48139-0799 - Phone
- (810) 893-7623
- Fax
- (810) 893-7624
- NPI assigned
- Oct 7, 2016
- Last updated
- Mar 9, 2020
- 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 | Primary | ||
| Physical Therapist | 225100000X | |||
| Occupational Therapist | 225X00000X |
Addresses
Primary practice location
10020 Professional Center Drive
Hamburg, MI 48139-0799
Mailing address
600 Oakmont LN Ste 600C
Westmont, IL 60559-5548
Phone (630) 575-6200
Other names 1
- ATHLETICO PHYSICAL THERAPY
National Provider Directory
National Provider Directory- Tax ID family
- Athletico LTD
Other organizations with this tax ID 42
Organizations that report the same tax identification number in the National Provider Directory.
Locations
10020 Professional Centre Dr
Whitmore Lake, MI 48189
Phone (810) 231-6905
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Physical Therapist
- Hamburg, MI
- NPI 1194967364
-
- Physical Therapist
- Hamburg, MI
- NPI 1578082012
-
- Physical Therapist
- Hamburg, MI
- NPI 1568122711
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475798400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1583712000000",
"number": "1861942377",
"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": "630-575-6200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10020 PROFESSIONAL CENTER DRIVE",
"city": "HAMBURG",
"state": "MI",
"postal_code": "481390799",
"telephone_number": "810-893-7623",
"fax_number": "810-893-7624"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ATHLETICO LTD",
"organizational_subpart": "NO",
"enumeration_date": "2016-10-07",
"last_updated": "2020-03-09",
"certification_date": "2020-03-09",
"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": null,
"license": null,
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": false
}
],
"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"
}
]
}
Other providers in Hamburg, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.