Individual provider Active NPI

Albert James Panozzo, RPH

  • Pharmacist
  • Mettawa, IL
National Provider Identifier
1770866980
Registry record updated Sep 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051028832 Issued in IL
Practice address
25901 N Riverwoods Rd
Mettawa, IL 60045-3403
Phone
(847) 235-1309
Fax
(847) 235-1306
NPI assigned
Sep 23, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051028832 IL Primary

Addresses

Primary practice location

25901 N Riverwoods Rd
Mettawa, IL 60045-3403

Mailing address

25901 N Riverwoods Rd
Mettawa, IL 60045-3403
Phone (847) 235-1309

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
051028832ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1316736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316736000000",
    "number": "1770866980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25901 N RIVERWOODS RD",
            "city": "METTAWA",
            "state": "IL",
            "postal_code": "600453403",
            "telephone_number": "847-235-1309",
            "fax_number": "847-235-1306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25901 N RIVERWOODS RD",
            "city": "METTAWA",
            "state": "IL",
            "postal_code": "600453403",
            "telephone_number": "847-235-1309",
            "fax_number": "847-235-1306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANOZZO",
        "first_name": "ALBERT",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-23",
        "last_updated": "2011-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051028832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mettawa, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2011; 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.