Organization
PANOPTIC PHYSICAL THERAPY LLC
Active
Parent organization
PANOPTIC PHYSICAL THERAPY, LLC
Other names
Panoptic Physical Therapy - Bourbonnais
Organization subpart
Yes
Provider details
NPI number
Legal business name
PANOPTIC PHYSICAL THERAPY, LLC
Authorized official
GERALD EDWARD MERTES III (CHIEF OPERATING OFFICER)
(815) 513-3298
Entity
Organization
Contact information
Practice address
1511 N. CONVENT ST SUITE 1000, BOURBONNAIS, IL 60914
(815) 401-5102
(815) 401-5103
Mailing address
1802 N DIVISION ST SUITE 202, MORRIS, IL 60450
(815) 513-3298
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
04/19/2019
Last updated
05/14/2019
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