Individual
DR. JOHN E CONNOLLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2233 W DIVISION ST, CHICAGO, IL 60622-8151
(312) 770-3990
(312) 770-2161
Mailing address
2233 W DIVISION ST, CHICAGO, IL 60622-8151
(312) 770-3990
(312) 770-2161
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036091823
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036091823
—
IL
Enumeration date
05/10/2006
Last updated
07/25/2007
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