Dr Lisa Marie Cannon, MD is a medicare enrolled "Colon & Rectal Surgery" physician in Chicago, Illinois. She went to University Of Rochester School Of Medicine And Dentistry and graduated in 2008 and has 16 years of diverse experience with area of expertise as Colorectal Surgery (proctology). She is a member of the group practice University Of Rochester Surgical Associates and her current practice location is
5841 S Maryland Ave, Mc 5094, Chicago, Illinois. You can reach out to her office (for appointments etc.) via phone at
(773) 834-3631.
Dr Lisa Marie Cannon is licensed to practice in Illinois (license number 036.132206) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1841450640.
Physician's Profile
| Full Name | Dr Lisa Marie Cannon |
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| Gender | Female |
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| Speciality | Colorectal Surgery (proctology) |
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| Experience | 16 Years |
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| Location | 5841 S Maryland Ave, Chicago, Illinois |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Lisa Marie Cannon attended and graduated from University Of Rochester School Of Medicine And Dentistry in 2008
NPI Data:
- NPI Number: 1841450640
- Provider Enumeration Date: 06/15/2008
- Last Update Date: 06/30/2023
Medicare PECOS Information:
- PECOS PAC ID: 0143449280
- Enrollment ID: I20190528001123
Medical Identifiers
Medical identifiers for Dr Lisa Marie Cannon such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1841450640 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208600000X | Surgery | 036.132206 (Illinois) | Secondary |
| 208C00000X | Colon & Rectal Surgery | 263195 (New York) | Secondary |
| 208C00000X | Colon & Rectal Surgery | 036.132206 (Illinois) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| University Of Rochester Surgical Associates | 8022919232 | 43 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Lisa Marie Cannon allows following entities to bill medicare on her behalf.
| Entity Name | University Of Rochester Surgical Associates |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1740205566
PECOS PAC ID: 8022919232
Enrollment ID: O20040120000191 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Lisa Marie Cannon is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Lisa Marie Cannon, MD
2300 N Lincoln Park W, 1208,
Chicago, IL 60614-3456
Ph: (585) 313-9787 | Dr Lisa Marie Cannon, MD
5841 S Maryland Ave, Mc 5094,
Chicago, IL 60637-1447
Ph: (773) 834-3631 |
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