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Individual

BRIAN E MCCANN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036095786
IL
208600000X
Surgery Physician
Primary
DR.0070039
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0002220321
BC/BS GROUP #
IL
01
020041966
RR MEDICARE PROVIDER#
IL
05
036095786
IL
01
CD5773
RR MEDICARE GROUP#
IL
Enumeration date
08/11/2005
Last updated
01/08/2023
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