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Athletico Ltd

Athletico Ltd is a healthcare organization registered as Clinic/Center in Edwardsville, IL, holding Type 2 (organization) NPI 1619570074 since 2020. The authorized official on file is Juana Granados, Credentialing Manager.

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NPI 1619570074
Entity type Organization (Type 2)
Legal business name Athletico Ltd
Practice address 1047 CENTURY DR, Edwardsville, IL, 62025
Phone 6183073434
Fax 6183073435
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
225X00000X Occupational Therapist Secondary
225100000X Physical Therapist Secondary
261Q00000X Clinic/Center Primary
Copy-ready billing details
Provider: Athletico Ltd
NPI: 1619570074
Taxonomy: 261Q00000X (Clinic/Center)
Address: 1047 CENTURY DR, Edwardsville, IL, 62025

Providers at this address

NPI Name Type Specialty Location
1659481737 Christopher Amick Individual Physical Therapist Edwardsville, IL
1851476378 Prorehab, PC Organization Physical Therapy Clinic/Center Edwardsville, IL
1508907395 Sean Campbell Individual Physical Therapist Edwardsville, IL
1043562192 Jennifer Hauschild Individual Occupational Therapist Edwardsville, IL
1740629914 Natalie Carter Individual Physical Therapist Edwardsville, IL
1407220940 Luke Makler Individual Physical Therapist Edwardsville, IL
1609395789 Teresa Garrels Individual Physical Therapist Edwardsville, IL
1861911760 James Wilhite Individual Physical Therapist Edwardsville, IL

Verify this record

Cross-check NPI 1619570074 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?
The practice location on file with NPPES is in Edwardsville, IL.
How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2020-11-18. Verify at npiregistry.cms.hhs.gov.

Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2020-11-18.