Individual
SARAH BRIGNOLE CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
4440 W 95TH ST STE 1332H, OAK LAWN, IL 60453-2600
(708) 684-5437
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209018680
IL
363LP0200X
Pediatric Nurse Practitioner
Primary
209018680
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041392684
ILLINOIS BOARD OF NURSING-RN LICENSE
IL
01
—
209018680
ILLINOIS BOARD OF NURSING
IL
Enumeration date
09/25/2019
Last updated
04/04/2025
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