Individual
MEGAN ELIZABETH BANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
225 E CHICAGO AVE, CHICAGO, IL 60611-2991
(312) 227-4000
Mailing address
1759 CREEK VIEW DR, FOGELSVILLE, PA 18051-1716
(484) 788-2338
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
125.075914
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2020
Last updated
04/29/2020
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