Individual
DR. JASON THOMAS CADWALLADER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
740 PEORIA ST, AURORA, CO 80011-8231
(720) 531-7111
(720) 640-3317
Mailing address
30 W MONROE ST, STE 1200, CHICAGO, IL 60603-2420
(312) 733-9730
(773) 866-8014
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01067114A
IN
207R00000X
Internal Medicine Physician
11013833A
IN
207R00000X
Internal Medicine Physician
Primary
DR.0074625
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000685913
ANTHEM
IN
05
—
200980050
—
IN
Enumeration date
05/21/2008
Last updated
04/22/2025
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