Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 036.129744 | IL |
NPI | 1154309284 |
---|---|
Provider Name | Ann Oconnor |
First Address | Winfield, IL 60190 |
Second Address | Winfield, IL 60190 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2006 |
Last Update Date | 27/01/2022 |