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Organization

DUPAGE PHYSICAL THERAPY PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANITA DEMETRA PANAGIOTIS MS PT (PRESIDENT OWNER)
(630) 653-9995
Entity
Organization

Contact information

Practice address
310 S COUNTY FARM RD, UNIT D, WHEATON, IL 60187
(630) 653-9995
(630) 653-9959
Mailing address
310 S COUNTY FARM RD, UNIT D, WHEATON, IL 60187
(630) 653-9995
(630) 653-9959

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2220622
BCBS
IL
01
7576630
AETNA
IL
01
C16248
RAILROAD MEDICARE
IL
Enumeration date
08/15/2006
Last updated
08/22/2020
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