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NPI 1942859509

NPI 1942859509 : JAMES JOSEPH CAHILL DMD : ALTON, IL

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General NPI Number Information
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    NPI Number           |    1942859509
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    Entity Type          |    Individual 
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    Provider Name        |    JAMES JOSEPH CAHILL DMD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/06/2019
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    Last Update Date     |    10/01/2019
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Provider Practice Location Address
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    Address Line         |    2800 COLLEGE AVE 
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    City                 |    ALTON
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    State                |    IL
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    Zip                  |    62002-4700
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    Country              |    US
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    Telephone            |    618-474-7125
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6160 TYRNBURY DR 
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    City                 |    LISLE
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    State                |    IL
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    Zip                  |    60532-3297
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    Country              |    US
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    Telephone            |    630-751-9215
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    019032203
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    License Number State |    IL
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Taxonomy #2
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    Taxonomy Code        |    122300000X
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    Taxonomy Name        |    Dentist
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    License Number       |    019032203
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    License Number State |    IL
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