Provider Demographics
NPI:1235224486
Name:BRIAN J CADY MD
Entity Type:Organization
Organization Name:BRIAN J CADY MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:CADY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-532-2320
Mailing Address - Street 1:1280 E TREMONT ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:IL
Mailing Address - Zip Code:62049-1912
Mailing Address - Country:US
Mailing Address - Phone:217-532-2320
Mailing Address - Fax:217-532-3857
Practice Address - Street 1:1280 E TREMONT ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:IL
Practice Address - Zip Code:62049-1912
Practice Address - Country:US
Practice Address - Phone:217-532-2320
Practice Address - Fax:217-532-3857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
IL143907Medicare ID - Type UnspecifiedRHC MEDICARE