Samuel Harrison Cannon Jr, | |
3302 Wembley Dr, Zion, IL 60099 | |
(847) 977-3483 | |
Not Available |
Full Name | Samuel Harrison Cannon Jr |
---|---|
Gender | Male |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 13 Years |
Location | 3302 Wembley Dr, Zion, Illinois |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1831432996 | NPI | - | NPPES |
100042105 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 041353866 (Illinois) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Aurora Medical Center Kenosha | Kenosha, WI | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Aurora Medical Group, Inc. | 6709794258 | 3269 |
Entity Name | Aurora Medical Group, Inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725 |
Entity Name | Stateline Anesthesiologists Sc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1316937519 PECOS PAC ID: 1355353822 Enrollment ID: O20060627000180 |
Entity Name | Brookfield Anesthesiologists Sc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1942257902 PECOS PAC ID: 5395847529 Enrollment ID: O20070219000542 |
Entity Name | Anesthesia Partners Services Sc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1861810947 PECOS PAC ID: 4082832514 Enrollment ID: O20140826000757 |
Entity Name | Polykarpos Anesthesia Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1154850972 PECOS PAC ID: 9436424629 Enrollment ID: O20171016000281 |
Mailing Address | Practice Location Address |
---|---|
Samuel Harrison Cannon Jr, 3302 Wembley Dr, Zion, IL 60099-4727 Ph: (847) 977-3483 | Samuel Harrison Cannon Jr, 3302 Wembley Dr, Zion, IL 60099 Ph: (847) 977-3483 |
Randy R Pomar, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2520 Elisha Ave, Zion, IL 60099 Phone: 847-872-6259 | |
Mrs. Emily T Penn, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: Cancer Treatment Centers Of America, 2520 Elisha Avenue, Zion, IL 60099 Phone: 800-322-9183 |