Individual
DESIRAY M CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3062 E 91ST ST, CHICAGO, IL 60617-4401
(773) 371-2900
Mailing address
8051 S ESSEX AVE APT 1N, CHICAGO, IL 60617-1264
(773) 512-6171
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150116837
IL
Other
Enumeration date
06/23/2026
Last updated
06/23/2026
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