| Panozzo Therapy, Inc | |
|
15915 S Crystal Creek Dr Unit E Homer Glen IL 60491-9284 | |
| (708) 846-2869 | |
| (708) 349-1464 |
| Full Name | Panozzo Therapy, Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 15915 S Crystal Creek Dr, Homer Glen, Illinois |
| Authorized Official Name and Position | Lisa Ann Panozzo (LICENSE CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 7088462869 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Panozzo Therapy, Inc Po Box 2351 Orland Park IL 60462-1030 Ph: (708) 846-2869 | Panozzo Therapy, Inc 15915 S Crystal Creek Dr Unit E Homer Glen IL 60491-9284 Ph: (708) 846-2869 |
| NPI Number | 1962822346 |
|---|---|
| Provider Enumeration Date | 04/23/2014 |
| Last Update Date | 04/23/2014 |
| Medicare PECOS PAC ID | 0749413110 |
|---|---|
| Medicare Enrollment ID | O20140509000926 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962822346 | NPI | - | NPPES |
| 216914 | Other | IL | PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 149.012262 (Illinois) | Primary |
| Provider Name | Lisa A Panozzo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598931867 PECOS PAC ID: 1658446844 Enrollment ID: I20080822000436 |
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