Individual
ANDREW CUSACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3335 N STERLING AVE, PEORIA, IL 61604-1837
(309) 672-4977
Mailing address
5100 RELIABLE PKWY, CHICAGO, IL 60686-0051
(309) 672-4809
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036.137856
IL
Other
Enumeration date
06/25/2012
Last updated
12/03/2015
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