Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 070-019935 | IL |
NPI | 1003258765 |
---|---|
Provider Name | Mary Catherine Casey |
First Address | Chicago, IL 60618 |
Second Address | Chicago, IL 60618 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2013 |
Last Update Date | 06/12/2018 |