Healthcare Provider Details

I. General information

NPI: 1588001275
Provider Name (Legal Business Name): ERIN BRIGH CAVANAUGH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2013
Last Update Date: 05/10/2021
Certification Date: 05/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 W TAYLOR ST STE 4C
CHICAGO IL
60612-4795
US

IV. Provider business mailing address

820 S WOOD ST # MC808
CHICAGO IL
60612-4325
US

V. Phone/Fax

Practice location:
  • Phone: 312-413-7500
  • Fax:
Mailing address:
  • Phone: 312-996-7006
  • Fax: 312-996-4238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMT204357
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number036.142711
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: