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NPI Profile for Dr MARY L GANNON in OAK BROOK, IL.
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
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Addiction Medicine |
2084A0401X | 79 | Physician/Addiction Medicine |
| NPI Number | 1235268541 |
|
| Status | Active | |
| Credentials | M.D.,C.A.D.C. | |
| Entity | Individual | |
| Enumeration date | 03/04/2007 | |
| Last updated | 05/17/2011 - About 15 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
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|
| Hospital affiliation(s) | Not Available |
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MARY L GANNON
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MARY L GANNON, M.D.,C.A.D.C.