Michael F Cannonie, D.O. – Family Medicine Physician

Key facts

NPI: 1720092273
Entity type: Individual (NPI type 1)
Primary specialty: Family Medicine Physician 207Q00000X
License: 036105058 (IL)
Practice address: 2000 McDonald Rd
South Elgin, IL 60177-3323
Phone: (224) 783-5000
NPI assigned: Jul 28, 2006
Sex: Male
Sole proprietor: No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Behavioral Wellness Inc Community Health Worker · Blue Island, IL · NPI 1235373325

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Osteopathy

Practice roles

Organization	Specialty	Status	New patients
Behavioral Wellness Inc		Past	Accepting new patients

Interoperability endpoints

FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Family Medicine Physician	207Q00000X	036105058	IL	Yes

Addresses

Primary practice location

2000 McDonald Rd
South Elgin, IL 60177-3323

Mailing address

2000 McDonald Rd
South Elgin, IL 60177-3323
Phone (224) 783-5000

Other identifiers

Identifier	Type	State	Issuer
BC7399125	Other		CONTROLLED SUBSTANCE

Other providers in South Elgin, IL

All providers in South Elgin, IL · Family Medicine Physician in Illinois

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2010. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.