Provider Demographics
NPI:1144219601
Name:CAHILL, JOHN J (PA-C)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:CAHILL
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37407 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-6050
Mailing Address - Country:US
Mailing Address - Phone:440-951-6038
Mailing Address - Fax:440-449-1101
Practice Address - Street 1:6770 MAYFIELD RD
Practice Address - Street 2:SUITE 348
Practice Address - City:MAYFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44124-2299
Practice Address - Country:US
Practice Address - Phone:440-449-1101
Practice Address - Fax:440-449-7715
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50-000293363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000336116OtherANTHEM
OHP00195664OtherRAILROAD MEDICARE
OHP00195664OtherRAILROAD MEDICARE
OHPA77901Medicare ID - Type Unspecified