Individual
STEPHANIE MARIA MCCANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
401 BICENTENNIAL WAY, SANTA ROSA, CA 95403-2149
(707) 653-3822
Mailing address
180 HARVESTER DRIVE, SUITE 110, BURR RIDGE, IL 60527
(773) 702-1150
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036142879
IL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/17/2012
Last updated
03/28/2024
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