Provider Demographics
NPI:1811046139
Name:PASCHAL J. PANIO, M.D., P.C.
Entity Type:Organization
Organization Name:PASCHAL J. PANIO, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PASCHAL
Authorized Official - Middle Name:J
Authorized Official - Last Name:PANIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-957-9404
Mailing Address - Street 1:1610 BUTTERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:FLOSSMOOR
Mailing Address - State:IL
Mailing Address - Zip Code:60422-1835
Mailing Address - Country:US
Mailing Address - Phone:708-799-5148
Mailing Address - Fax:
Practice Address - Street 1:18237 KEDZIE AVE
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-1411
Practice Address - Country:US
Practice Address - Phone:708-957-9404
Practice Address - Fax:708-957-9462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036050124207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILD13262Medicare UPIN
IL497481Medicare ID - Type Unspecified