Kerry Panozzo MD PC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

036090677 Issued in IL

Legal business name

KERRY PANOZZO MD PC

Practice address

4110 Blackhawk Rd Ste 2
Suite #2
Rock Island, IL 61201-7039

Phone

(309) 428-7055

Fax

(309) 265-0118

NPI assigned

Jan 11, 2006

Organization subpart

No

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

Authorized official

Name

Kerry P Panozzo, MD

Title

President

Phone

(309) 762-9711

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433894400000",
    "number": "1265411987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 BLACKHAWK RD STE 2",
            "address_2": "SUITE #2",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612017039",
            "telephone_number": "309-428-7055",
            "fax_number": "309-265-0118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 BLACKHAWK RD STE 2",
            "address_2": "SUITE #2",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612017039",
            "telephone_number": "309-428-7055",
            "fax_number": "309-265-0118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KERRY PANOZZO MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-11",
        "last_updated": "2015-06-10",
        "status": "A",
        "authorized_official_last_name": "PANOZZO",
        "authorized_official_first_name": "KERRY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-762-9711",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036090677",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "036090677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0535666",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1535666",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Dennis Keeley, DPM
• Gloria M Keeslar, LCPC
• Natividad Keim
• Lester Kelty, MD
• Kathryn Ann Kennedy, SLP
• Muhammad Yasir Khan
• Ola Mahmoud Ali Khraiwesh, MD
• Mark T Kienle, DDS
• Stefanie Kincaid
• Libna T King, CADC

• Pain Medicine (Anesthesiology) Physician in Rock Island, IL
• Providers in Rock Island, IL by specialty
• Pain Medicine (Anesthesiology) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2015; 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.