NPI
Charles Anthony Cavallo
NPI 1174733521
Read from the NPPES registry on October 23, 2026.
Facts
- Status
- Active
- Credential
- MD
- Type
- Individual
- Enumeration date
- 2007-05-23
- Last updated
- 2020-06-24
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Specialties
Licenses
- License IL
- 036041159
- License NY
- 258002
- License IL
- 036-041159
Location
- Practice location
- 3132 Old Jacksonville Rd Ste 110
- City
- Springfield IL
- Postal code
- 62704-7401
- Phone
- (217) 588-2600
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
No exclusion found for this NPI in the OIG LEIE file dated October 9, 2026. Confirm on OIG's online search.
Nearby
Other NPIs in Springfield, IL. 5,943 records in the public file.
Public data from NPPES and CMS. Not a credentialing determination.
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