Individual provider Active NPI

Joseph J Panzo, DC

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1366639056
Registry record updated Sep 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Practice address
6614 S Halsted St
Suite 103
Chicago, IL 60621-1812
Phone
(773) 783-0303
Fax
(773) 783-2300
NPI assigned
Sep 26, 2007
Last updated
Sep 26, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X IL Primary

Addresses

Primary practice location

6614 S Halsted St
Suite 103
Chicago, IL 60621-1812

Mailing address

6614 S Halsted St
Suite 103
Chicago, IL 60621-1812
Phone (773) 783-0303

Other identifiers 3

IdentifierTypeStateIssuer
300600OtherILMEDICARE PART B
01608208OtherILBLUE CROSS/BLUE SHIELD
01633482OtherILBLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
038007862ILMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190764800000",
    "number": "1366639056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6614 S HALSTED ST",
            "address_2": "SUITE 103",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606211812",
            "telephone_number": "773-783-0303",
            "fax_number": "773-783-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6614 S HALSTED ST",
            "address_2": "SUITE 103",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606211812",
            "telephone_number": "773-783-0303",
            "fax_number": "773-783-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANZO",
        "first_name": "JOSEPH",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-26",
        "last_updated": "2007-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "300600",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "01608208",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "01633482",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2007; 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.