Provider Demographics
NPI:1184209645
Name:CADY, CASSANDRA DIANE (APRN, CNP)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:DIANE
Last Name:CADY
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:MS
Other - First Name:CASSANDRA
Other - Middle Name:
Other - Last Name:BOSSERT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN, CNP
Mailing Address - Street 1:40 75TH ST
Mailing Address - Street 2:
Mailing Address - City:WILLOWBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60527-2325
Mailing Address - Country:US
Mailing Address - Phone:630-581-5372
Mailing Address - Fax:
Practice Address - Street 1:138 W PARK AVE APT 2W
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-3376
Practice Address - Country:US
Practice Address - Phone:630-804-9142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-16
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209022305363LF0000X
IL1184209645363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily