Individual
DR. J MICHAEL PANUSKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
230 JOHN CASEY RD., BOURBONNAIS, IL 60914
(815) 937-8788
Mailing address
1001 COBB BLVD, KANKAKEE, IL 60901-5335
(815) 935-0460
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036-072073
IL
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
036-072073
IL
Other
Enumeration date
12/22/2006
Last updated
12/22/2021
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