Cavanagh, Patrick J

Cavanagh, Patrick J is an individual health care provider with primary practice located at 550 Southland Dr Ste 2, Decatur IL 62521-4080. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Cavanagh, Patrick J can be contacted via phone (217) 425-9264.

Contact Information

Primary practice address
550 Southland Dr Ste 2 Decatur IL 62521-4080
Phone: (217) 425-9264
Fax: (217) 425-5983
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036096619 Illinois

Profile Details

NPI number 1669439584
LBN Legal business name Cavanagh, Patrick J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2006
Last updated Aug 20th, 2014 - about 10 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 1669439584 NPPES
Illinois MEDICAID 036096619

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