Provider Demographics
NPI:1356380281
Name:CLAMAN, CASSANDRA (MD)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:CLAMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8549 FREY RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANT PLAINS
Mailing Address - State:IL
Mailing Address - Zip Code:62677-3961
Mailing Address - Country:US
Mailing Address - Phone:217-836-0621
Mailing Address - Fax:
Practice Address - Street 1:8549 FREY RD
Practice Address - Street 2:
Practice Address - City:PLEASANT PLAINS
Practice Address - State:IL
Practice Address - Zip Code:62677-3961
Practice Address - Country:US
Practice Address - Phone:217-836-0621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036097933207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILE58115Medicare UPIN
ILK23904Medicare ID - Type Unspecified