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Organization

MPAC OF WISCONSIN SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SEAN CANNONE DO (OWNER/CMO)
(888) 660-4425
Entity
Organization

Contact information

Practice address
3000 N HALSTED ST STE 803, CHICAGO, IL 60657-6185
(888) 705-8722
Mailing address
2045 W GRAND AVE STE B, #28354, CHICAGO, IL 60612-1577
(888) 705-8722
(888) 705-8722

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary

Other

Enumeration date
06/27/2018
Last updated
11/26/2024
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