Individual
BRIAN A CANAVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2160 S FIRST AVENUE, LOYOLA UNIVERSITY MEDICAL CENTER, CHICAGO, IL 60153
(617) 838-3852
Mailing address
225 N COLUMBUS DR, APT 2403, CHICAGO, IL 60601-7910
(617) 838-3852
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036.118840
IL
Other
Enumeration date
08/23/2005
Last updated
10/07/2010
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