Provider Demographics
NPI:1215021027
Name:DR SILVIA PANITCH LTD
Entity Type:Organization
Organization Name:DR SILVIA PANITCH LTD
Other - Org Name:LAKEVIEW INTEGRATIVE MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT / MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SILVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PANITCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-525-6595
Mailing Address - Street 1:7434 LOWELL AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-3830
Mailing Address - Country:US
Mailing Address - Phone:847-675-5231
Mailing Address - Fax:847-675-5231
Practice Address - Street 1:3344 N ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-2109
Practice Address - Country:US
Practice Address - Phone:773-525-6595
Practice Address - Fax:773-525-6596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036063863207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL4050OtherMEDICARE PTAN
IL036063863Medicaid
IL036063863Medicaid