Individual
AYANNA JEANNETTE MCKINNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
18 CHICAGO AVE, OAK PARK, IL 60302
(773) 253-3933
(773) 437-6780
Mailing address
18 CHICAGO AVE, OAK PARK, IL 60302-2402
(773) 253-3933
(773) 437-6780
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
036-138620
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036138620
—
IL
Enumeration date
04/15/2011
Last updated
03/21/2019
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