Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Mark Robert Gannon, PT

Individual provider Physical Therapist · NPI 1093737397

Mr. Mark Robert Gannon, PT is a Physical Therapist in Private Practice in Oak Brook, Illinois. Qualified in 2005, 21 years ago. Practices with Orthomidwest, PLLC, a 537-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Arizona and Illinois.

Years since qualifying
21
Licensed in
AZ, IL
In the registry since
2006
Specialties on file
2
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

2011 York Rd Ste 1500
Oak Brook, IL 60523
Phone: (877) 632-6637
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 6309 E Baywood Ave, Mesa, AZ 85206-1744 — (480) 325-3801
  • 6309 E Baywood Ave, Mesa, AZ 85206-1744 — (480) 325-3801

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 070024237 (IL)
Physical Therapist Taxonomy 225100000X · Licence 6877 (AZ)

Record details

NPI number1093737397
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorNo
NPI enumeratedJuly 24, 2006
Last updated in NPPESJune 7, 2019
Mailing address600 Oakmont Ln Ste 600c, Westmont, IL 60559-5548

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Orthomidwest, Pllc — 537 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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