Organization
FOREFRONT ADULT & PEDIATRIC CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL A PANZICA M.D. (BUSINESS OWNER)
(815) 485-8380
Entity
Organization
Contact information
Practice address
1938 E LINCOLN HWY STE 106, NEW LENOX, IL 60451-3927
(815) 485-8380
(815) 485-1116
Mailing address
1938 E LINCOLN HWY STE 106, NEW LENOX, IL 60451-3927
(815) 485-8380
(815) 485-1116
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
042-618128
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036095398
—
IL
Enumeration date
05/11/2007
Last updated
09/09/2008
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