Individual
DR. LLOYD CHARLES CASSIDY IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
124 SIEGLER ST, GREEN BAY, WI 54303-2636
(920) 605-3115
(920) 486-6826
Mailing address
353 N DESPLAINES ST APT 607, CHICAGO, IL 60661-1245
(847) 502-2979
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036144493
IL
207Q00000X
Family Medicine Physician
Primary
70125
WI
207Q00000X
Family Medicine Physician
Q6620
TX
Other
Enumeration date
04/18/2013
Last updated
01/27/2021
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