Amy L Panoka, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070013248 Issued in IL

Practice address

150 E Huron St
Suite 901
Chicago, IL 60611-2999

Phone

(312) 640-1112

Fax

(312) 640-1011

NPI assigned

Apr 26, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Amy L Rudnick Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228262400000",
    "number": "1770703407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 W WACKER DR",
            "address_2": "SUITE 1020",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606061216",
            "telephone_number": "312-640-0329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 E HURON ST",
            "address_2": "SUITE 901",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112999",
            "telephone_number": "312-640-1112",
            "fax_number": "312-640-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANOKA",
        "first_name": "AMY",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2008-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070013248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL",
            "identifier": "1619980",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "RUDNICK",
            "middle_name": "L",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Audrey Joan Panko, MD
• Silvana Pannain
• Amy L Pannaralla
• Janet Pannaralla, D.D.S.
• Parambathu Cynthia Nambiar Panniyoth Valiya
• Nicholas Elias Panomitros, DDS
• Panos Dentistry Center
• Panos Dentistry Center Inc.
• Angelo Panos, DDS
• Ariella Panos, PA-C

• Physical Therapist in Chicago, IL
• Providers in Chicago, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2008; 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.