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NPI Code Detail

MEDICARE: DR. SEAN DENNIS OCONNOR M.D.

MEDICARE: DR. SEAN DENNIS OCONNOR M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician03697642IL

General Provider Information

NPI Number : 1609831528
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SEAN DENNIS OCONNOR M.D.
Provider Business Mailing Address
First Line : 211 E CHICAGO AVE
Second Line : SUITE 1050
City : CHICAGO
State : IL
Zip : 60611-2637
Country : US
Telephone Number : 312-944-6677
Fax Number : 312-944-3346
Provider Business Practice Location Address
First Line : 211 E CHICAGO AVE
Second Line : SUITE 1050
City : CHICAGO
State : IL
Zip : 60611-2637
Country : US
Telephone Number : 312-944-6677
Fax Number : 312-944-3346
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2006
Last Update Date : 07/08/2007

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