Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 071009026 | IL |
Y | 103TC0700X | Clinical Psychologist | 071009026 | IL |
NPI | 1003206830 |
---|---|
Provider Name | Casey E Noreika |
First Address | Melrose Park, IL 60160-1422 |
Second Address | Melrose Park, IL 60160-1422 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2015 |
Last Update Date | 02/02/2015 |