Dr. Mark M. Connolly
Surgical Oncologist
2913 N Commonwealth Ave 5th Floor
Chicago
, Illinois 60657-6211
Dr. Mark M. Connolly
Surgical Oncologist
2913 N Commonwealth Ave 5th Floor
Chicago
, Illinois 60657-6211
(773) 472-8561
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About
Features
Specialties
- Surgical Oncologist
Languages spoken
- English
Location
First Address
- Dr. Mark M. Connolly
- Po Box 597995
- Chicago, IL
- Zip : 60659-7995
- Fax : (773) 472-8561
- Phone : (773) 472-3427
Second Address
- Dr. Mark M. Connolly
- 2913 N Commonwealth Ave 5th Floor
- Chicago, IL
- Zip : 60657-6211
- Fax : (773) 472-8561
- Phone : (773) 472-3427
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2086X0206X | Surgical Oncologist | 036063941 | IL |
National Provider Identifier
| NPI | 1033162839 |
|---|---|
| Provider Name | Dr. Mark M. Connolly |
| First Address | Chicago, IL 60659-7995 |
| Second Address | Chicago, IL 60657-6211 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/05/2006 |
| Last Update Date | 30/03/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0001618161 | BCBS OF IL (01) | IL |
| 036063941 | (05) | IL |
| C44346 | (02) | IL |
| P00261094 | MEDICARE RAILROAD PART B (01) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.