Individual provider Active NPI

Stacy Panozzo, D.O.

  • Internal Medicine Physician
  • Gurnee, IL
National Provider Identifier
1316292592
Registry record updated Jun 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036136766 Issued in IL
Practice address
731 S Il Route 21 Ste 130
Gurnee, IL 60031-3803
Phone
(847) 566-3337
Fax
(847) 816-3166
NPI assigned
Jul 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036136766 IL Primary

Addresses

Primary practice location

731 S Il Route 21 Ste 130
Gurnee, IL 60031-3803

Mailing address

731 S Il Route 21 Ste 130
Gurnee, IL 60031-3803
Phone (847) 566-3337

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address spanozzo256283@direct.northshore.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150626000399 IL Practitioner - Internal Medicine 4183935570 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Evanston, IL 60201-1700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
125-060895ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Internal Medicine CurrentSince Jul 20, 2015 Accepting new patients
Endeavor Health Medical Group CurrentSince Jul 20, 2015 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

731 S State Route 21
Gurnee, IL 60031
Phone (847) 247-0187

731 S State Route 21
Ste 130
Gurnee, IL 60031
Phone (847) 566-3337

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1342137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781740800000",
    "number": "1316292592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 S IL ROUTE 21 STE 130",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600313803",
            "telephone_number": "847-566-3337",
            "fax_number": "847-816-3166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 S IL ROUTE 21 STE 130",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600313803",
            "telephone_number": "847-566-3337",
            "fax_number": "847-816-3166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANOZZO",
        "first_name": "STACY",
        "name_prefix": "Ms.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-13",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036136766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "spanozzo256283@direct.northshore.org",
            "affiliation": "N",
            "address_1": "731 S Il Route 21 Ste 130",
            "city": "Gurnee",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600313803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gurnee, IL

Sources for this page

Verify at the official NPI Registry.