Individual
DAVID F KAVANAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
901 GRANT ST, HARVARD, IL 60033-1821
(815) 943-5431
(815) 943-5460
Mailing address
901 GRANT ST, HARVARD, IL 60033-1821
(815) 943-5431
(815) 943-5460
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036-101675
IL
207P00000X
Emergency Medicine Physician
05248
IA
207P00000X
Emergency Medicine Physician
40398-021
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
$$$$$$$$$
—
IL
01
—
080142264CD3624
RR MEDICARE
IL
05
—
1437176070
—
WI
01
—
P00448088CG6042
RR MEDICARE
IL
Enumeration date
07/17/2006
Last updated
08/02/2023
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