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General NPI Number Information
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NPI Number | 1225158728
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Entity Type | Individual
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Provider Name | JEFFREY MICHAEL PANZER M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 03/24/2017
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Provider Practice Location Address
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Address Line | 1273 N MILWAUKEE AVE
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City | CHICAGO
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State | IL
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Zip | 60622-9318
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Country | US
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Telephone | 773-570-3340
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Fax | 773-453-9191
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Provider Business Mailing Address
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Address Line | 1273 N MILWAUKEE AVE
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City | CHICAGO
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State | IL
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Zip | 60622-9318
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Country | US
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Telephone | 773-570-3340
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Fax | 773-453-9191
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036-124689
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD436189
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License Number State | PA
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