Panoptic Physical Therapy LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

PANOPTIC PHYSICAL THERAPY LLC

Practice address

1511 N Convent St Ste 1000
Bourbonnais, IL 60914-1497

Phone

(815) 401-5102

Fax

(815) 401-5103

NPI assigned

Apr 3, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Larry Luke Panozzo Jr., SLP

Title

President

Phone

(815) 513-3298

Specialties & licenses 1

Addresses

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Panoptic Physical Therapy LLC

  • Physical Medicine & Rehabilitation Physician
  • Bourbonnais, IL
  • NPI 1740843267
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575504000000",
    "number": "1053873513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 NORTH DIVISION STREET, SUITE 202",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "60450",
            "telephone_number": "815-513-3298",
            "fax_number": "815-513-5446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 N CONVENT ST STE 1000",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141497",
            "telephone_number": "815-401-5102",
            "fax_number": "815-401-5103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANOPTIC PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-03",
        "last_updated": "2019-12-05",
        "status": "A",
        "authorized_official_last_name": "PANOZZO",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "LUKE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-513-3298",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "SLP"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Omolara Aminat Oshokoya, APRN
• Samuel Osobu, D.M.D
• Tammie Jo Ostrowski, PT
• Sheryl Ann Palinski, LCPC
• Pamela Ford Counseling Limited
• Panoptic Physical Therapy LLC
• Panoptic Physical Therapy LLC
• Michael Albert Panozzo, RFA
• J Michael Panuska, MD, MPH
• Azra N Pappa, DO

• Physical Medicine & Rehabilitation Physician in Bourbonnais, IL
• Providers in Bourbonnais, IL by specialty
• Physical Medicine & Rehabilitation Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.