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General NPI Number Information
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NPI Number | 1124093570
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Entity Type | Individual
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Provider Name | JOHN N PANOPOULOS DC
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Gender | Male
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Dates
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Enumeration Date | 02/21/2006
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Last Update Date | 07/23/2020
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Provider Practice Location Address
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Address Line | 1550 N NORTHWEST HWY STE 206
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City | PARK RIDGE
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State | IL
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Zip | 60068-1459
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Country | US
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Telephone | 847-739-3120
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Fax | 847-886-4025
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Provider Business Mailing Address
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Address Line | PO BOX 2308
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City | GLEN ELLYN
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State | IL
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Zip | 60138-2308
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Country | US
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Telephone | 847-739-3120
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Fax | 847-886-4025
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038009079
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License Number State | IL
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