Individual
DR. LISA MARIE CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5841 S MARYLAND AVE, MC 5094, CHICAGO, IL 60637-1447
(773) 834-3631
Mailing address
2300 N LINCOLN PARK W, 1208, CHICAGO, IL 60614-3456
(585) 313-9787
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036.132206
IL
208C00000X
Colon & Rectal Surgery Physician
Primary
036.132206
IL
208C00000X
Colon & Rectal Surgery Physician
263195
NY
Other
Enumeration date
06/15/2008
Last updated
06/30/2023
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