Anita Demetra Panagiotis, MS PT

Individual provider Active NPI Physical Therapist · Wheaton, IL

NPI 1497760060 · NPPES record last updated Sep 20, 2011

Key facts

NPI
1497760060
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
070003081 (IL)
Practice address
310 S County Farm Rd
Unit D
Wheaton, IL 60187
Phone
(630) 653-9995
Fax
(630) 653-9959
NPI assigned
Jul 30, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
070003081ILMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070003081 IL Yes

Addresses

Primary practice location

310 S County Farm Rd
Unit D
Wheaton, IL 60187

Mailing address

310 S County Farm Rd
Unit D
Wheaton, IL 60187
Phone (630) 653-9995

Other identifiers

IdentifierTypeStateIssuer
7576630OtherILAETNA
C16248OtherILRAILROAD MEDICARE
070003081OtherILBCBS

Other providers in Wheaton, IL

All providers in Wheaton, IL · Physical Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.