Individual
GREGORY CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
250 ARBON CT, CRETE, IL 60417-1121
(708) 704-2427
Mailing address
250 ARBON CT, CRETE, IL 60417-1121
(708) 704-2427
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/07/2016
Last updated
04/07/2016
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