Ethan E Pettiway (NPI# 1023153558, PAC ID# 1052569787) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL THERAPY.
| Nation Provider ID (NPI) | 1023153558 |
| PAC ID by PECOS | 1052569787 |
| Professional Enrollment ID | I20120920000808 |
| Full Name | Ethan E Pettiway |
| Organization Legal Name | ATHLETICO LTD |
| Address |
407 N Lagrange Rd Lagrange Park IL 60526-5623 |
| Phone Number | 7084829320 |
| Gender | M |
| Graduation Year | 2005 |
| Primary Specialty | PHYSICAL THERAPY |
| Group Practice PAC ID | 4789602681 |
| Number of Group Practice Members | 810 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 500 N Kingsbury St, Chicago, IL 60654-5721 | 3125275801278 | ATHLETICO LTD |
| 407 N Lagrange Rd, Lagrange Park, IL 60526-5623 | 7084829320 | ATHLETICO LTD |
| Organization Legal Name | ATHLETICO LTD |
| Physicians | 815 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Carolyn Brady | Physical Therapy | Athletico Ltd | 430 Milwaukee Ave, Suite Aa, Lincolnshire, IL 60069-3016 |
| Wesley J Horn | Physical Therapy | Athletico Ltd | 405 N Wabash Ave, Chicago, IL 60611-3591 |
| Julianne M Phillips | Physical Therapy | Athletico Ltd | 14700 S La Grange Rd, Suite A, Orland Park, IL 60462-3250 |
| Lauren Anne Macnab | Physical Therapy | Athletico Ltd | 1479 S Lee St, Des Plaines, IL 60018-1516 |
| Alec Hirschauer | Physical Therapy | Athletico Ltd | 5045 Bentley Dr, Suite 190, West Des Moines, IA 50265-7010 |
| Jordan M Ruedt | Physical Therapy | Athletico Ltd | 3077 N Mayfair Rd, Suite 105, Wauwatosa, WI 53222-4305 |
| Bernade Buena | Physical Therapy | Athletico Ltd | 1137 N Eola Rd, Suite 106, Aurora, IL 60502-7097 |
| Calvin K Ip | Physical Therapy | Athletico Ltd | 500 N Kingsbury St, Chicago, IL 60654-5721 |
| Olivia L Perozzi | Physical Therapy | Athletico Ltd | 223 W Jackson Blvd, Suite 225, Chicago, IL 60606-6908 |
| Arpit J Pathak | Physical Therapy | Athletico Ltd | 770 W Bartlett Rd, Bartlett, IL 60103-4482 |
| Street Address |
407 N LAGRANGE RD |
| City | LAGRANGE PARK |
| State | IL |
| Zip | 60526-5623 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Scott Stephen Racz | Physical Therapy | Athletico Ltd | 407 N Lagrange Rd, Lagrange Park, IL 60526-5623 |
| Colin M Mattiace | Physical Therapy | Athletico Ltd | 407 N Lagrange Rd, Lagrange Park, IL 60526-5623 |
| Melissa Hayman | Physical Therapy | Athletico Ltd | 407 N Lagrange Rd, Lagrange Park, IL 60526-5623 |
| Colleen L Wood | Physical Therapy | Athletico Ltd | 407 N Lagrange Rd, Lagrange Park, IL 60526-5623 |
| Bozana Durman-grbic | Occupational Therapy | Athletico Ltd | 407 N Lagrange Rd, Lagrange Park, IL 60526-5623 |
| Sarah M Dawson | Physical Therapy | Athletico Ltd | 407 N Lagrange Rd, Lagrange Park, IL 60526-5623 |
| Jennifer C Curry | Physical Therapy | Athletico Ltd | 407 N Lagrange Rd, Lagrange Park, IL 60526-5623 |
| Kathleen Marie Prampin | Physical Therapy | Athletico Ltd | 407 N Lagrange Rd, Lagrange Park, IL 60526-5623 |
| Kyla M Galles | Physical Therapy | Athletico Ltd | 407 N Lagrange Rd, Lagrange Park, IL 60526-5623 |
| Laura C Campbell | Physical Therapy | Athletico Ltd | 407 N Lagrange Rd, Lagrange Park, IL 60526-5623 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Francis James Di Iorio | Chiropractic | 48 E 31st St, Suite 3and4, La Grange Park, IL 60526-1024 | |
| Glenn Roger Londos | Optometry | 1103 E 31st St, La Grange Park, IL 60526-1280 | |
| Karen Bradley | Nurse Practitioner | Chicago Rehabilitation Collective LLC | 315 N La Grange Rd, La Grange, IL 60526-1903 |
| Leslie Bassell | Nurse Practitioner | Chicago Rehabilitation Collective LLC | 315 N La Grange Rd, La Grange, IL 60526-1903 |
| Ramesh P Melvani | Internal Medicine | 344 Sherwood Rd, La Grange Park, IL 60526-1967 | |
| Robert J Groya | Orthopedic Surgery | 348 Sherwood Rd, La Grange Park, IL 60526-1967 | |
| Douglas Ryan Evenhouse | Chiropractic | 442 Sherwood Rd, La Grange, IL 60526-1968 | |
| Joseph Z Hura | Family Practice | Lagrange Family Care Center Ltd | 412 Sherwood Rd, La Grange Park, IL 60526-1968 |
| Michael J Glavin | Ophthalmology | 426 Sherwood Rd, La Grange Park, IL 60526-1968 | |
| Michael Rex Pinckney | Chiropractic | 442 Sherwood Rd, La Grange, IL 60526-1968 | |
| Find all physicians in zip 60526 | |||
| City | LAGRANGE PARK |
| Zip Code | 60526 |
| Specialty | PHYSICAL THERAPY |
| City + Specialty | LAGRANGE PARK + PHYSICAL THERAPY |
Please comment or provide details below to improve the information on Ethan E Pettiway.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.