Mary L. Gannon in Glen Ellyn - Addiction Medicine
Mary L. Gannon - NPI 1235268541
Mary L. Gannon is a Addiction Medicine in Glen Ellyn, Illinois. Mary L. Gannon practices all healthcare services and medical treatments related to Addiction Medicine. The NPI Number for Mary L. Gannon is 1235268541. The last update date is 2011-05-17.
Mary L. Gannon's current location address is 326 Grandview Ave, Glen Ellyn, Illinois. You can contact this provider via phone number 6309814886. The mailing address for Mary L. Gannon is 326 Grandview Ave, Glen Ellyn, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mary L. Gannon |
|---|---|
| Address | 326 Grandview Ave, Glen Ellyn, Illinois |
| Phone Number | 6309814886 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | M.D.,C.A.D |
NPI Number Detail
| NPI Number | 1235268541 |
|---|---|
| Provider Enumeration Date | 2007-03-04 |
| Last Updated Date | 2011-05-17 |
Provider Mailing Address Detail
| Address | 326 Grandview Ave |
|---|---|
| City | Glen Ellyn |
| State | Illinois (IL) |
| Post Code | 601375220 |
| Phone Number | 6309814886 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Addiction Medicine |
|---|---|
| Taxonomy | 2084A0401X |
| Licence No | 36068239 |
|
Definition: A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 234667000 | KY | MAGELLAN BEHAVIORAL HEALT | |
| 133348420017 | KY | HUMANA | |
| GANNMARY | KY | CORPHEALTH |
Post Comment/ Review Below
What is the unique identification code assigned to Mary L. Gannon by the Centers for Medicare & Medicaid Services?
The Mary L. Gannon has been issued the NPI (National Provider Identifier) 1235268541. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Mary L. Gannon is geographically located?
The Mary L. Gannon is physically situated at the following location: 326 Grandview Ave, Glen Ellyn, IL, 601375220.
What is Mary L. Gannon's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Mary L. Gannon is Addiction Medicine, and the taxonomy code that categorizes this field of expertise is 2084A0401X.
When did Mary L. Gannon receive its 1235268541 assignment?
The Mary L. Gannon was assigned its 1235268541 on 2007-03-04, which is the date when this unique identifier was issued to the organization.
When was the information regarding Mary L. Gannon most recently updated?
The details pertaining to the Mary L. Gannon, including its address, specialty, and other relevant information, were last refreshed on 2011-05-17.