Athletico Ltd
Athletico Ltd is a healthcare organization registered as Clinic/Center in Fairview Heights, IL, holding Type 2 (organization) NPI 1154924512 since 2020. The authorized official on file is Juana Granados, Credentialing Manager.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1154924512 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Athletico Ltd |
| Practice address | 5300 N ILLINOIS ST STE 101, Fairview Heights, IL, 62208 |
| Phone | 6186249300 |
| Fax | 6186249330 |
| Enumeration date | 2020-11-18 |
| Last updated in NPPES | 2020-11-18 |
Authorized official
| Name | Juana Granados |
|---|---|
| Title | Credentialing Manager |
| Phone | 6305751980 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 225100000X | Physical Therapist | Secondary | — | — |
| 225X00000X | Occupational Therapist | Secondary | — | — |
| 261Q00000X | Clinic/Center | Primary | — | — |
Copy-ready billing details
Provider: Athletico Ltd NPI: 1154924512 Taxonomy: 261Q00000X (Clinic/Center) Address: 5300 N ILLINOIS ST STE 101, Fairview Heights, IL, 62208
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1164702247 | Kaitlin Duross | Individual | Physical Therapist | Fairview Heights, IL |
| 1053848341 | Alison Krack | Individual | Student in an Organized Health Care Education/Training Program | Fairview Heights, IL |
| 1134610298 | Vernon Modglin | Individual | Physical Therapist | Fairview Heights, IL |
| 1265143481 | Erin Moranville | Individual | Occupational Therapist | Fairview Heights, IL |
| 1598550469 | Roshani Brahmbhatt | Individual | Physical Therapist | Fairview Heights, IL |
Verify this record
Cross-check NPI 1154924512 against the authoritative CMS record: view Athletico Ltd on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
Where is Athletico Ltd located?
How current is this record?
Source: CMS NPPES (public data). Snapshot 2026-07-10. Provider record last updated 2020-11-18.