Organization
PANOPTIC PHYSICAL THERAPY LLC
Active
Parent organization
PANOPTIC PHYSICAL THERAPY LL
Other names
Panoptic Physical Therapy - Bourbonnais
Organization subpart
Yes
Provider details
NPI number
Legal business name
PANOPTIC PHYSICAL THERAPY LL
Authorized official
MR. GERALD EDWARD MERTES III LNHA (CHIEF OPERATING OFFICER)
(815) 513-3298
Entity
Organization
Contact information
Practice address
1521 N CONVENT ST, SUITE 1000, BOURBONNAIS, IL 60914
(815) 210-9010
(815) 513-5446
Mailing address
1802 DIVISION ST, SUITE 202, MORRIS, IL 60450
(815) 513-3298
(815) 513-5446
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
05/16/2019
Last updated
05/16/2019
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