Individual
DR. BRYAN CHARLES MCCONOMY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801-2529
(217) 383-3129
(217) 326-1550
Mailing address
611 W PARK ST, URBANA, IL 61801-2529
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01082365A
IN
207R00000X
Internal Medicine Physician
MD-42937
IA
208M00000X
Hospitalist Physician
Primary
036156550
IL
208M00000X
Hospitalist Physician
MD-42937
IA
Other
Enumeration date
05/24/2013
Last updated
03/24/2022
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