Individual
MICHAEL MCCONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
12490 BUSINESS CENTER DR STE 200, VICTORVILLE, CA 92395-5833
(760) 728-1900
Mailing address
1229 BULL VALLEY DR, WOODSTOCK, IL 60098-8084
(847) 533-6498
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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