# KERRY PANOZZO MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265411987
- **Authorized official:** KERRY P PANOZZO MD (PRESIDENT)
- **Authorized official phone:** (309) 762-9711

## Contact information

- **Practice address:** 4110 BLACKHAWK RD STE 2, SUITE \#2, ROCK ISLAND, IL 61201-7039
- **Practice address phone:** (309) 428-7055
- **Practice address fax:** (309) 265-0118
- **Mailing address:** 4110 BLACKHAWK RD STE 2, SUITE \#2, ROCK ISLAND, IL 61201-7039
- **Mailing address phone:** (309) 428-7055
- **Mailing address fax:** (309) 265-0118

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | 036090677 | IL | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 036090677 | IL | Yes |

## Other

- **Enumeration date:** 01/11/2006
- **Last updated:** 06/10/2015