Gannon, Patrick Gerard

Gannon, Patrick Gerard is an sole proprietor health care provider with primary practice located at 626 Bethany Rd 3251 Commerce Drive, Dekalb IL 60115-4939. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Gannon, Patrick Gerard can be contacted via phone (815) 756-1521.

Contact Information

Primary practice address
626 Bethany Rd 3251 Commerce Drive Dekalb IL 60115-4939
Phone: (815) 756-1521
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X Illinois
Allopathic & Osteopathic Physicians / General Practice 208D00000X Illinois

Profile Details

NPI number 1720187453
LBN Legal business name Gannon, Patrick Gerard
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 21st, 2006
Last updated Jul 8th, 2007 - about 17 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 1720187453 NPPES
Illinois Other 237087041;651249587 TAX ID NUMBER
Illinois Other 021940024;0031940152 TAX ID NUMBER

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