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Contact Information

CHARLES A CAVALLO, MD
3132 OLD JACKSONVILLE RD STE 110
SPRINGFIELD, IL62704-7401
 Phone: 217-588-2600
 Fax: 217-862-0904
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for CHARLES A CAVALLO · (Male)

NPI Number 1174733521
Status Active
Credentials MD
Entity Individual
Enumeration date 05/23/2007
Last updated 06/24/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 036-041159
  • IL License # 036041159
  • NY License # 258002
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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