MEDICARE: MARY CATHERINE CASEY DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	070-019935	IL

General Provider Information

NPI Number	:	1003258765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY CATHERINE CASEY DPT

Provider Business Mailing Address
First Line	:	4020 N ROCKWELL ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-3721
Country	:	US
Telephone Number	:	773-844-0240
Fax Number	:

Provider Business Practice Location Address
First Line	:	4022 N ROCKWELL
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618
Country	:	US
Telephone Number	:	773-844-0240
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2013
Last Update Date	:	06/27/2023

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