Organization
INTERVENTIONS IN PAIN MANAGEMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERRY PANOZZO MD (OWNER)
(309) 428-7055
Entity
Organization
Contact information
Practice address
4110 BLACKHAWK RD, ROCK ISLAND, IL 61201-7039
(309) 428-7055
Mailing address
PO BOX 689, LAKE FOREST, IL 60045-0689
(847) 615-2200
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
036090677
IL
261QP3300X
Pain Clinic/Center
Primary
—
—
Other
Enumeration date
01/24/2014
Last updated
05/06/2016
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