Individual
DR. ROBERT W CAVANAGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D
Contact information
Practice address
435 W DIVERSEY PKWY, CHICAGO, IL 60614-6163
(708) 798-9313
(708) 798-9312
Mailing address
18001 BAKER AVE, COUNTRY CLUB HILLS, IL 60478-5046
(708) 798-9313
(708) 798-9312
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001673536
BLUE CROSS BLUE SHIELDPPO
IL
Enumeration date
03/17/2007
Last updated
07/08/2007
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