Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Sports Physical Therapy & Rehab Specialist SC

Organization Physical Therapist · NPI 1417455528

Sports Physical Therapy & Rehab Specialist SC is a Physical Therapist in Union Grove, Wisconsin. Licensed in Illinois. Registered with an NPI since 2018.

Licensed in
IL
In the registry since
2018
Specialties on file
3

Practice location Address checks out

1201 Main St
Union Grove, WI 53182-1303
Phone: (262) 878-9602
Fax: (262) 878-9609
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinic/Center (primary) Taxonomy 261Q00000X
Physical Therapist Taxonomy 225100000X (IL)
Occupational Therapist Taxonomy 225X00000X

Record details

NPI number1417455528
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Juana Granados — Credentialing Manager · (630) 575-1980
Other names Athletico Physical Therapy; Athletico Physical Therapy
NPI enumeratedJanuary 24, 2018
Last updated in NPPESApril 6, 2018
Mailing address600 Oakmont Ln, Westmont, IL 60559-5548

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