Cassidy, Jason Leo

Cassidy, Jason Leo is an individual health care provider with primary practice located at 701 N 1St St , Springfield IL 62781-2329. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Cassidy, Jason Leo can be contacted via phone (217) 788-3000.

Contact Information

Primary practice address
701 N 1St St Springfield IL 62781-2329
Phone: (217) 788-3000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 209.020724 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 2001022867 Missouri

Profile Details

NPI number 1649276429
LBN Legal business name Cassidy, Jason Leo
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 25th, 2005
Last updated Feb 11th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649276429 NPPES
Illinois Other 209020724 CRNA LICENSE
Illinois MEDICAID 919107201 CRNA LICENSE
Illinois Other P00133340 CRNA LICENSE

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