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General NPI Number Information
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NPI Number | 1093280133
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Entity Type | Individual
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Provider Name | NANCY L PANZICA LCPC
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Gender | Female
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Dates
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Enumeration Date | 10/04/2018
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Last Update Date | 03/26/2022
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Provider Practice Location Address
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Address Line | 18328 ASHLAND AVE
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City | HOMEWOOD
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State | IL
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Zip | 60430-3403
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Country | US
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Telephone | 708-820-8250
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Fax | 708-478-3036
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Provider Business Mailing Address
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Address Line | 1706 LYNWOOD CT
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City | FLOSSMOOR
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State | IL
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Zip | 60422-1932
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Country | US
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Telephone | 708-275-7195
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Fax | 708-478-3036
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 178013844
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 180014343
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License Number State | IL
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