Cannon, Vernon Terence

Cannon, Vernon Terence is an individual health care provider with primary practice located at 231 S Gary Ave Ste 114, Bloomingdale IL 60108-2234. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Cannon, Vernon Terence can be contacted via phone (630) 893-8585.

Contact Information

Primary practice address
231 S Gary Ave Ste 114 Bloomingdale IL 60108-2234
Phone: (630) 893-8585
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 036116379 Illinois

Profile Details

NPI number 1740293703
LBN Legal business name Cannon, Vernon Terence
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 14th, 2006
Last updated Jan 20th, 2011 - about 15 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 1740293703 NPPES
Illinois MEDICAID 036116379
Illinois Other P00714795

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