Individual
ANTONIO PANGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2160 S 1ST AVE, (7511 LEMONT RD, DARIEN, IL. 60561), MAYWOOD, IL 60153
(630) 985-4989
(630) 985-4540
Mailing address
2160 S 1ST AVE, (7511 LEMONT RD, DARIEN, IL. 60561), MAYWOOD, IL 60153
(630) 985-4989
(630) 985-4540
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36103232
IL
208000000X
Pediatrics Physician
036103232
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36103232
—
IL
Enumeration date
02/28/2006
Last updated
07/23/2009
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