Individual
SOPHIA HOPE KANNENBERG O' BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
720 FLORSHEIM DR, LIBERTYVILLE, IL 60048-3757
(847) 247-4000
(847) 234-2090
Mailing address
1000 E ROLLINS RD, ROUND LAKE BEACH, IL 60073-2228
(847) 324-3976
(847) 929-1154
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085-006740
IL
Other
Enumeration date
09/11/2018
Last updated
08/02/2023
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