| Stephanie Cavanaugh Md Llc | |
|
1210 Spruce St Winnetka IL 60093-2148 | |
| (847) 587-6112 | |
| (847) 587-6113 |
| Full Name | Stephanie Cavanaugh Md Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1210 Spruce St, Winnetka, Illinois |
| Authorized Official Name and Position | Stephanie Cavanaugh (PRESIDENT) |
| Authorized Official Contact | 8475876112 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stephanie Cavanaugh Md Llc 1210 Spruce St Winnetka IL 60093-2148 Ph: (847) 587-6112 | Stephanie Cavanaugh Md Llc 1210 Spruce St Winnetka IL 60093-2148 Ph: (847) 587-6112 |
| NPI Number | 1679934939 |
|---|---|
| Provider Enumeration Date | 03/15/2016 |
| Last Update Date | 03/15/2016 |
| Medicare PECOS PAC ID | 5890093264 |
|---|---|
| Medicare Enrollment ID | O20160419000500 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679934939 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 036041963 (Illinois) | Primary |
| Provider Name | Stephanie V Cavanaugh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073523015 PECOS PAC ID: 1254409063 Enrollment ID: I20081007000467 |
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