Michael Cavanaugh, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

036-043738 Issued in IL

Practice address

1790 Nations Dr
Suite 102
Gurnee, IL 60031-9164

Phone

(847) 662-4455

Fax

(847) 662-9940

NPI assigned

Aug 11, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• North Shore Allergy and Asthma, S.C.

  • Specialist
  • Gurnee, IL
  • NPI 1467567156
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359331200000",
    "number": "1407858376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1790 NATIONS DR",
            "address_2": "SUITE 102",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600319164",
            "telephone_number": "847-662-4455",
            "fax_number": "847-662-9940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 NATIONS DR",
            "address_2": "SUITE 102",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600319164",
            "telephone_number": "847-662-4455",
            "fax_number": "847-662-9940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVANAUGH",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2013-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036-043738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cree L Carter
• Arielle Casaclang, DMD
• Cynthia Baldovino Casaclang, DDS
• Timothy J Casey, D.P.M.
• Michelle Catenacci, MD
• Center for Pelvic Wellness, Inc.
• Samra Cerim, APN-CNP
• Samarendra Chandel, MD
• Alix A Charles, MD
• Alejandra Chavez Hernandez

• Specialist in Gurnee, IL
• Providers in Gurnee, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.