Individual
BERNETTA CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
237 W 95TH ST, CHICAGO, IL 60628-1321
(773) 468-2110
Mailing address
237 W 95TH ST, CHICAGO, IL 60628-1321
(773) 468-2110
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.025522
IL
Other
Enumeration date
04/05/2023
Last updated
04/05/2023
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