Cannon, Lisa Marie

Cannon, Lisa Marie is an individual health care provider with primary practice located at 5841 S Maryland Ave Mc 5094, Chicago IL 60637-1447. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Colon & Rectal Surgery. Allopathic & Osteopathic Physicians / Colon & Rectal Surgery is her primary health care specialty. Cannon, Lisa Marie can be contacted via phone (773) 834-3631.

Contact Information

Primary practice address
5841 S Maryland Ave Mc 5094 Chicago IL 60637-1447
Phone: (773) 834-3631
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 036.132206 Illinois
Allopathic & Osteopathic Physicians / Colon & Rectal Surgery 208C00000X 263195 New York
Allopathic & Osteopathic Physicians / Colon & Rectal Surgery 208C00000X 036.132206 Illinois

Profile Details

NPI number 1841450640
LBN Legal business name Cannon, Lisa Marie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2008
Last updated Jun 30th, 2023 - about 2 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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