DR. CHARLES ANTHONY CAVALLO (NPI# 1174733521) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174733521 |
| Entity Type | Individual |
| Full Name | DR. CHARLES ANTHONY CAVALLO |
| Credential | MD |
| Practice Address |
3132 Old Jacksonville Rd Ste 110 Springfield IL 62704-7401 |
| Mailing Address |
Po Box 3428 Springfield IL 62708-3428 |
| Practice Telephone | 2175882600 |
| Practice Fax Number | 2178620904 |
| Mailing Telephone | 8005775368 |
| Mailing Fax Number | 2177572021 |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-06-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 036-041159 | IL | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 258002 | NY | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 036041159 | IL | Allopathic & Osteopathic Physicians |
| Y | 208600000X | Surgery | 036041159 | IL | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 258002 | NY | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508849399 | Charles Albert Cavallo | Pediatrics | 2865 Chancellor Dr, Suite 225, Crestview Hills, KY 41017-3912 | 2005-11-25 |
| Street Address |
3132 OLD JACKSONVILLE RD STE 110 |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62704-7401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982205514 | Breanne L Larson | Nurse Practitioner | 3132 Old Jacksonville Rd Ste 110, Springfield, IL 62704-7401 | 2020-11-02 |
| 1134421506 | Anna Maria Lentini | Nurse Practitioner | 3132 Old Jacksonville Rd Ste 110, Springfield, IL 62704-7401 | 2010-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902394901 | Hillary Haaker | Occupational Therapist | 2035 W Iles, Suite C, Springfield, ID 62704 | 2018-04-25 |
| 1871095364 | Edward Doyle Slifer Sr. | Pathology | 2117 Greenside Drive, Spring Field, IL 62704 | 2018-03-01 |
| 1598263345 | Santarelli & Feller Dental Group | Dentist | 1140 Rickard Road, Suite B, Springfield, IL 62704 | 2018-01-26 |
| 1447774757 | Lisa Ann Rogers | Developmental Therapist | 2101 Lexington Dr, Apt 3, Springfield, IL 62704 | 2017-07-28 |
| 1730611286 | Mindi Rowe | Occupational Therapist | 2508 County Rd 4 1/2 E, Springfield, IL 62704 | 2017-04-03 |
| 1366992208 | Jayme Jordan | Contractor | 2409 Westchester Blvd, Springfield, IL 62704 | 2016-10-04 |
| 1154793974 | Dina Payne | Social Worker | 917 Clocktower Drive, Suite 600, Springfield, IL 62704 | 2015-10-21 |
| 1770959819 | James R Reynolds | Hearing Instrument Specialist | 2347 W Monroe St, Springfield, IL 62704 | 2015-08-12 |
| 1336576495 | Emily Jane Dungey | Counselor | 920 S Spring St Ste 1300, Springfield, IL 62704 | 2013-10-03 |
| 1942552161 | Jeannie Marie Hundley | Specialist/Technologist, Other | 2921 Monvale Drive, Springfield, IL 62704 | 2012-10-11 |
| Find all providers in zip 62704 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184114480 | New Jersey Bariatric Group, PC | Surgery | 193 Morris Ave Fl 2, Springfield, NJ 07081-1211 | 2018-05-14 |
| 1174903488 | Samuel J Rheinhardt | Surgery | 701 N 1st St Ste D327, Springfield, IL 62702-3757 | 2015-06-02 |
| 1588099725 | Francis Milton Corry | Surgery | 2859 E. Utica, Springfield, MO 65804 | 2013-09-06 |
| 1881033926 | Frank A. Cornella Dds, Md PC | Surgery | 3237 E Sunshine St Ste B, Springfield, MO 65804-6919 | 2013-06-21 |
| 1881943678 | Roland Folse | Surgery | 2 Virginia Lane, Springfield, IL 62712 | 2012-09-07 |
| 1780939462 | Daniel Caleb Persinger | Surgery | 100 W Mccreight Ave Ste 110, Springfield, OH 45504-1890 | 2012-07-18 |
| 1154618775 | Alexandria Dailey Mcdow | Surgery | 701 N 1st St Ste D308, Springfield, IL 62702-3757 | 2011-07-04 |
| 1356655054 | Allison Melissa Key | Surgery | 1965 S Fremont Ave Ste 230, Springfield, MO 65804-2258 | 2010-08-05 |
| 1679704761 | James P Buwen | Surgery | 193 Morris Ave, 2nd Floor, New Jersey Bariatric Center, Springfield, NJ 07081 | 2009-08-06 |
| 1386871069 | Lindsey Leigh Saint | Surgery | 315 W Carpenter St Fl 2, Springfield, IL 62702 | 2009-06-19 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62704 |
Please comment or provide details below to improve the information on DR. CHARLES ANTHONY CAVALLO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.