Panozzo Therapy, Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

149.012262 Issued in IL

Legal business name

PANOZZO THERAPY, INC

Practice address

15915 S Crystal Creek Dr
Unit E
Homer Glen, IL 60491-9284

Phone

(708) 846-2869

Fax

(708) 349-1464

NPI assigned

Apr 23, 2014

Organization subpart

No

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

Authorized official

Name

Lisa Ann Panozzo, LCSWNPI 1598931867

Title

License Clinical Social Worker

Phone

(708) 846-2869

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisa Ann Panozzo, LCSW

  • Clinical Social Worker
  • Homer Glen, IL
  • NPI 1598931867
  Medicare reassignment NPD Authorized official
• Melissa Ann Peterson, MSW, LSW

  • Social Worker
  • Lockport, IL
  • NPI 1801668009
  NPD (past)

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

{
    "created_epoch": "1398211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398211200000",
    "number": "1962822346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2351",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604621030",
            "telephone_number": "708-846-2869",
            "fax_number": "708-349-1464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15915 S CRYSTAL CREEK DR",
            "address_2": "UNIT E",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604919284",
            "telephone_number": "708-846-2869",
            "fax_number": "708-349-1464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANOZZO THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-23",
        "last_updated": "2014-04-23",
        "status": "A",
        "authorized_official_last_name": "PANOZZO",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "LICENSE CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "708-846-2869",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "149.012262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "216914",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Orland Pharmacy, Inc.
• Orthopedic Physical Therapy Services LLC
• Harry William Oryhon, DDS
• Helen Owens, P.T.
• Genabeth M Panes, LPT
• Lisa Ann Panozzo, LCSW
• Patricia Clark MD LLC
• Mark J Peloquin, D.D.S.
• W Michael Petty, ATC, LAT
• Phoenix Surgical Services

• Community/Behavioral Health Agency in Homer Glen, IL
• Providers in Homer Glen, IL by specialty
• Community/Behavioral Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.