Panozzo, Kerry P

Panozzo, Kerry P is an sole proprietor health care provider with primary practice located at 4110 Blackhawk Rd Ste 2 , Rock Island IL 61201-7039. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Pain Medicine is his primary health care specialty. Panozzo, Kerry P can be contacted via phone (309) 428-7055.

Contact Information

Primary practice address
4110 Blackhawk Rd Ste 2 Rock Island IL 61201-7039
Phone: (309) 428-7055
Fax: (309) 265-0118
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 036090677 Illinois
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X 036090677 Illinois

Profile Details

NPI number 1225017957
LBN Legal business name Panozzo, Kerry P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 11th, 2006
Last updated May 29th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225017957 NPPES
Illinois MEDICAID 036090677

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