MEDICARE: MICHAEL A. CASCIO DDS LTD

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	1223G0001X	General Practice Dentistry	6351980	IL

General Provider Information

NPI Number	:	1184867038
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL A. CASCIO DDS LTD

Provider Business Mailing Address
First Line	:	7340 W LAWRENCE AVE
Second Line	:
City	:	HARWOOD HEIGHTS
State	:	IL
Zip	:	60706-3504
Country	:	US
Telephone Number	:	708-867-0100
Fax Number	:	708-867-8741

Provider Business Practice Location Address
First Line	:	7340 W LAWRENCE AVE
Second Line	:
City	:	HARWOOD HEIGHTS
State	:	IL
Zip	:	60706-3504
Country	:	US
Telephone Number	:	708-867-0100
Fax Number	:	708-867-8741

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MICHAEL ALBERT CASCIO
Credential	:	DDS
Telephone Number	:	708-867-0100

Provider Enumeration Date	:	04/08/2009
Last Update Date	:	04/08/2009

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