Individual
AMY L PANOKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
150 E HURON ST, SUITE 901, CHICAGO, IL 60611-2999
(312) 640-1112
(312) 640-1011
Mailing address
205 W WACKER DR, SUITE 1020, CHICAGO, IL 60606-1216
(312) 640-0329
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070013248
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619980
BCBS OF IL
IL
Enumeration date
04/26/2007
Last updated
12/03/2008
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