MEDICARE: MICHAEL D CASHMAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	036051017	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	809840	OTHER	IL	MEDICARE GROUP #

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881635605
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL D CASHMAN M.D.

Provider Business Mailing Address
First Line	:	2805 N KNOXVILLE AVE
Second Line	:
City	:	PEORIA
State	:	IL
Zip	:	61604-2869
Country	:	US
Telephone Number	:	309-624-9400
Fax Number	:	309-624-2280

Provider Business Practice Location Address
First Line	:	2805 N KNOXVILLE AVE
Second Line	:
City	:	PEORIA
State	:	IL
Zip	:	61604-2869
Country	:	US
Telephone Number	:	309-624-9400
Fax Number	:	309-624-2280

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2006
Last Update Date	:	01/10/2012

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