National Provider Identifier Database

MARY L GANNON, M.D.,C.A.D.C. – NPI #1235268541
Addiction Medicine

A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine


Contact Information

MARY L GANNON, M.D.,C.A.D.C.
2625 BUTTERFIELD RD
SUITE 103 W
OAK BROOK, IL60523-1234
Phone: 630-981-4886
Fax:
Website:
Specialty Taxonomy Code
* Addiction Medicine 2084A0401X

* Indicates primary specialty

NPI Profile & details for MARY L GANNON

NPI Number 1235268541
Credentials M.D.,C.A.D.C.
Entity Individual
Enumeration date 03/04/2007
Last updated 05/17/2011 - About 15 years ago
Sole proprietor1 Yes
Identifiers
  • IL License #: 036068239
  • KY Other: GANNMARY CORPHEALTH
  • KY Other: 133348420017 HUMANA
  • KY Other: 234667000 MAGELLAN BEHAVIORAL HEALT
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for MARY L GANNON, M.D.,C.A.D.C.

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