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Individual

DR. MICHAEL F CANNONIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
2000 MCDONALD RD, SOUTH ELGIN, IL 60177-3323
(224) 783-5000
Mailing address
2000 MCDONALD RD, SOUTH ELGIN, IL 60177-3323
(224) 783-5000

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036105058
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
BC7399125
CONTROLLED SUBSTANCE
Enumeration date
07/28/2006
Last updated
10/18/2010
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