Provider Demographics
NPI:1568420172
Name:PANAGAS, ROSEMARIE (MD)
Entity Type:Individual
Prefix:MS
First Name:ROSEMARIE
Middle Name:
Last Name:PANAGAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 N ELM ST
Mailing Address - Street 2:SUITE 123
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3634
Mailing Address - Country:US
Mailing Address - Phone:630-856-6865
Mailing Address - Fax:630-856-6813
Practice Address - Street 1:911 N ELM ST
Practice Address - Street 2:SUITE 123
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3634
Practice Address - Country:US
Practice Address - Phone:630-325-5709
Practice Address - Fax:630-325-0388
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36069089207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036069089Medicaid