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 | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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) | Primary |
208D00000X | General Practice | (Illinois) | Primary |
Mailing Address | Practice Location Address |
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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 |