Connolly, Mark M.

Connolly, Mark M. is an individual health care provider with primary practice located at 2913 N Commonwealth Ave 5Th Floor, Chicago IL 60657-6211. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgical Oncology, which is considered as his primary health care specialty. Connolly, Mark M. can be contacted via phone (773) 472-3427.

Contact Information

Primary practice address
2913 N Commonwealth Ave 5Th Floor Chicago IL 60657-6211
Phone: (773) 472-3427
Fax: (773) 472-8561
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgical Oncology 2086X0206X 036063941 Illinois

Profile Details

NPI number 1033162839
LBN Legal business name Connolly, Mark M.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 19th, 2006
Last updated Mar 30th, 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 1033162839 NPPES
Illinois MEDICAID 036063941
Illinois Other P00261094
Illinois Other 0001618161

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