PANOPTIC PHYSICAL THERAPY LLC (NPI# 1639735418) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639735418 |
| Entity Type | Organization |
| Organization Name | PANOPTIC PHYSICAL THERAPY LLC |
| Practice Address |
1521 N Convent St Suite 1000 Bourbonnais IL 60914 |
| Mailing Address |
1802 Division St Suite 202 Morris IL 60450 |
| Practice Telephone | 8152109010 |
| Practice Fax Number | 8155135446 |
| Mailing Telephone | 8155133298 |
| Mailing Fax Number | 8155135446 |
| Enumeration Date | 2019-05-16 |
| Last Update Date | 2019-05-16 |
| Authorized Official Name | MR. GERALD EDWARD MERTES III (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 8155133298 |
| Authorized Official Credential | LNHA |
| Is Organization Subpart | Y |
| Parent Organization Name | PANOPTIC PHYSICAL THERAPY LL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Panoptic Physical Therapy - Bourbonnais | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740843267 | Panoptic Physical Therapy LLC | Physical Medicine & Rehabilitation | 1511 N. Convent St Suite 1000, Bourbonnais, IL 60914 | 2019-04-19 |
| 1053873513 | Panoptic Physical Therapy LLC | Physical Medicine & Rehabilitation | 1511 N Convent St Ste 1000, Bourbonnais, IL 60914-1497 | 2019-04-03 |
| Street Address |
1521 N CONVENT ST SUITE 1000 |
| City | BOURBONNAIS |
| State | IL |
| Zip Code | 60914 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750494142 | Scott P. Fogel Dds PC | Dentist | 1521 N Convent St, Suite 600, Bourbonnais, IL 60914-1468 | 2006-08-17 |
| 1720450786 | Chicago Hearing LLC | Hearing Aid Equipment | 1521 N Convent St, Suite 300, Bourbonnais, IL 60914-1468 | 2015-10-29 |
| 1366825465 | Ernest Lee Smith IIi | Hearing Instrument Specialist | 1521 N Convent St, Bourbonnais, IL 60914-1468 | 2015-07-07 |
| 1417159385 | American Medical Group,ltd | Internal Medicine | 1521 N Convent St, Bourbonnais, IL 60914-1468 | 2007-06-04 |
| 1699847848 | Illinois Laser & Vein Center, LLC | Clinic/Center | 1521 N Convent St, Bourbonnais, IL 60914-1468 | 2006-11-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648023 | Jacob Daniel Ledesma | Physical Therapist | 588 William R Latham Senior Dr Ste 5, Bourbonnais, IL 60914 | 2020-10-30 |
| 1467069823 | Alicia Nicole Kendra | Nurse Practitioner | Upliftedcare, 482 Main St. Nw, Bourbonnais, IL 60914 | 2020-09-29 |
| 1043860877 | Victor Manuel Vazquez Cervantes | Pharmacist | 2080 No, Il-50, Bourbonnais, IL 60914 | 2019-09-13 |
| 1740843267 | Panoptic Physical Therapy LLC | Physical Medicine & Rehabilitation | 1511 N. Convent St Suite 1000, Bourbonnais, IL 60914 | 2019-04-19 |
| 1770074577 | Colin P Koerner | Physical Therapist | 215 N Convent St Ste 6, Bourbonnais, IL 60914 | 2018-05-29 |
| 1306337340 | Megan Hoskins | Behavior Technician | 3187 N 2420 W Rd., Bourbonnais, IL 60914 | 2018-05-25 |
| 1932600459 | Thomas H George Dds PC | Clinic/Center | 14 Briarcliff Professional Center, Bourbonnais, IL 60914 | 2018-02-21 |
| 1780193904 | Kathleen M Saindon II | Speech-Language Pathologist | 1021 Deer Trail, Bourbonnais, IL 60914 | 2017-09-20 |
| 1457870206 | Janet Mary Notton | Speech-Language Pathologist | 920 W Margaret Lane, Bourbonnais, IL 60914 | 2017-09-13 |
| 1134646375 | Sagar Batish | Student in an Organized Health Care Education/Training Program | 1096 Country Lane, Bourbonnais, IL 60914 | 2017-08-28 |
| Find all providers in zip 60914 | ||||
| Taxonomy Code | 208100000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Physical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and treating patients with physical disabilities. These disabilities may arise from conditions affecting the musculoskeletal system such as neck and back pain, sports injuries, or other painful conditions affecting the limbs, such as carpal tunnel syndrome. Alternatively, the disabilities may result from neurological trauma or disease such as spinal cord injury, head injury or stroke. A physician certified in physical medicine and rehabilitation is often called a physiatrist. The primary goal of the physiatrist is to achieve maximal restoration of physical, psychological, social and vocational function through comprehensive rehabilitation. Pain management is often an important part of the role of the physiatrist. For diagnosis and evaluation, a physiatrist may include the techniques of electromyography to supplement the standard history, physical, x-ray and laboratory examinations. The physiatrist has expertise in the appropriate use of therapeutic exercise, prosthetics (artificial limbs), orthotics and mechanical and electrical devices. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. American Osteopathic Board of Physical Medicine and Rehabilitation, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Physical Medicine and Rehabilitation. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740843267 | Panoptic Physical Therapy LLC | Physical Medicine & Rehabilitation | 1511 N. Convent St Suite 1000, Bourbonnais, IL 60914 | 2019-04-19 |
| 1053873513 | Panoptic Physical Therapy LLC | Physical Medicine & Rehabilitation | 1511 N Convent St Ste 1000, Bourbonnais, IL 60914-1497 | 2019-04-03 |
| 1336594282 | Kyle Boudreau | Physical Medicine & Rehabilitation | 1511 N Convent St, Bourbonnais, IL 60914 | 2016-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164023982 | Tabitha Lyn Ganske | Physical Medicine & Rehabilitation | 27 Auerbach Pl, Glen Carbon, IL 62034-1596 | 2020-11-06 |
| 1366056731 | Morgan Proctor | Physical Medicine & Rehabilitation | West Suburban Nursing and Rehabilitation, 311 Edgewater Drive, Bloomingdale, IL 60108 | 2020-09-03 |
| 1316569064 | Boss Povieng | Physical Medicine & Rehabilitation | 1620 W Harrison St Ste 403, Chicago, IL 60612-3801 | 2020-05-15 |
| 1265052781 | Nomad Enterprises | Physical Medicine & Rehabilitation | 5100 Forest Ave Unit 208, Downers Grove, IL 60515-4855 | 2020-04-24 |
| 1205488590 | Michelle E Roberts | Physical Medicine & Rehabilitation | 225 S Sangamon St Ste 1, Chicago, IL 60607-5167 | 2019-07-16 |
| 1104487289 | Ping Wang | Physical Medicine & Rehabilitation | 2320 Kalamazoo Dr, Naperville, IL 60565-6327 | 2019-06-27 |
| 1255999744 | Neil Dominic Seno Villarosa | Physical Medicine & Rehabilitation | 7313 Woodward Ave Apt 301, Woodridge, IL 60517-2549 | 2019-05-30 |
| 1609335942 | Urlacherehab | Physical Medicine & Rehabilitation | 141 N Maple St, Palatine, IL 60067-4910 | 2019-03-16 |
| 1750849428 | Ovation Hand Institute, LLC | Physical Medicine & Rehabilitation | 737 N Michigan Ave Ste 2200, Chicago, IL 60611-6750 | 2019-03-12 |
| 1336612043 | Elly Heber | Physical Medicine & Rehabilitation | 6912 176th Pl, Tinley Park, IL 60477-3841 | 2019-01-04 |
| Find all providers with the same taxonomy | ||||
| City | BOURBONNAIS |
| Zip Code | 60914 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.