# PANOPTIC PHYSICAL THERAPY LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PANOPTIC PHYSICAL THERAPY, LLC
- **Other names:** Panoptic Physical Therapy - Bourbonnais
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1740843267
- **Legal business name:** PANOPTIC PHYSICAL THERAPY, LLC
- **Authorized official:** GERALD EDWARD MERTES III (CHIEF OPERATING OFFICER)
- **Authorized official phone:** (815) 513-3298

## Contact information

- **Practice address:** 1511 N. CONVENT ST SUITE 1000, BOURBONNAIS, IL 60914
- **Practice address phone:** (815) 401-5102
- **Practice address fax:** (815) 401-5103
- **Mailing address:** 1802 N DIVISION ST SUITE 202, MORRIS, IL 60450
- **Mailing address phone:** (815) 513-3298

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/19/2019
- **Last updated:** 05/14/2019