Individual
MICHAEL MCCONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036.139705
IL
2085R0202X
Diagnostic Radiology Physician
20A20719
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036.139705
MEDICAL LICENSE
IL
Enumeration date
05/27/2010
Last updated
05/08/2025
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