| Dr Patrick Gerard Gannon, DO | |
|
626 Bethany Rd, 3251 Commerce Drive, Dekalb, IL 60115-4939 | |
| (815) 756-1521 | |
| Not Available |
| Full Name | Dr Patrick Gerard Gannon |
|---|---|
| Gender | Male |
| Speciality | General Practice |
| Location | 626 Bethany Rd, Dekalb, Illinois |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720187453 | NPI | - | NPPES |
| 237087041;651249587 | Other | IL | TAX ID NUMBER |
| 021940024;0031940152 | Other | IL | BCBS PRVIDER # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | (Illinois) | Secondary |
| 208D00000X | General Practice | (Illinois) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Patrick Gerard Gannon, DO 2807 Brittany Ct, St Charles, IL 60175-5161 Ph: () - | Dr Patrick Gerard Gannon, DO 626 Bethany Rd, 3251 Commerce Drive, Dekalb, IL 60115-4939 Ph: (815) 756-1521 |
Dr. Brian David Lamere, MD General Practice Medicare: Medicare Enrolled Practice Location: 518 Lucinda Avenue, Health Services, Northern Illinois University, Dekalb, IL 60115 Phone: 815-753-1311 Fax: 815-753-9599 | |
Dr. John Landis Bowman, MD General Practice Medicare: Not Enrolled in Medicare Practice Location: Health Services, Northern Illinois University, Dekalb, IL 60115 Phone: 815-753-1311 Fax: 815-753-9599 |