Individual
DR. EMMET MICHAEL CASSIDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18646 DIXIE HWY, HOMEWOOD, IL 60430-3715
(708) 647-6635
(708) 647-6649
Mailing address
18646 DIXIE HWY, HOMEWOOD, IL 60430-3715
(708) 647-6635
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036092971
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01620861
BLUE CROSS AND BLUE SHIELD
IL
05
—
036092971
—
IL
01
—
1083684922
THE ESC GROUP NPI
IL
01
—
180046212
MEDICARE RAILROAD
IL
01
—
205785
PTAN IL MEDICARE COOK COUNTY
IL
01
—
P00379235
MEDICARE RAILROAD
IL
Enumeration date
03/31/2006
Last updated
02/01/2011
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