Individual
BRENT A PANNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
800 DES PLAINES AVE, FOREST PARK, IL 60130-2035
(708) 366-2442
(708) 366-0179
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2222
(630) 759-9510
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.010064
IL
Other
Enumeration date
05/13/2015
Last updated
06/04/2015
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