Cannell, Warren

Cannell, Warren is an individual health care provider with primary practice located at 101 E Miller Rd , Sterling IL 61081-1252. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Cannell, Warren can be contacted via phone (815) 625-4790.

Contact Information

Primary practice address
101 E Miller Rd Sterling IL 61081-1252
Phone: (815) 625-4790
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036099762 Illinois

Profile Details

NPI number 1932299005
LBN Legal business name Cannell, Warren
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2006
Last updated Jul 6th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932299005 NPPES
Illinois Other 9815737 BLUE CROSS BLUE SHIELD
Illinois Other 047835 BLUE CROSS BLUE SHIELD
Illinois MEDICAID 036099762 BLUE CROSS BLUE SHIELD

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