Individual
MARY CONNOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1220 HOBSON RD, 204, NAPERVILLE, IL 60540-8139
(630) 416-7766
Mailing address
1860 PAYSPHERE CIR, CHICAGO, IL 60674-0018
(630) 416-7766
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036121843
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036121843
—
IL
Enumeration date
05/09/2008
Last updated
01/20/2011
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