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Contact Information

MARK R GANNON, PT
2011 YORK RD STE 1500
OAK BROOK, IL60523
 Phone: 877-632-6637
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for MARK R GANNON · (Male)

NPI # 1093737397
Status Active
Credentials PT (Physical Therapist)
Entity Individual
Enumeration date 07/24/2006
Last updated 06/07/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • AZ License # 6877
  • IL License # 070024237
Hospital affiliation(s) Not Available
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.

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