Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Sports Physical Therapy & Rehab Specialist SC

Organization Physical Therapist · NPI 1417455528

Sports Physical Therapy & Rehab Specialist SC provides Physical Therapist services 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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