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NPI Code Detail

MEDICARE: DR. CASEY DYCUS DC

MEDICARE: DR. CASEY DYCUS DC
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
1111N00000XChiropractor038.014172IL

General Provider Information

NPI Number : 1235963893
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CASEY DYCUS DC
Provider Business Mailing Address
First Line : 7432 HANCOCK DR
Second Line :
City : WONDER LAKE
State : IL
Zip : 60097-9200
Country : US
Telephone Number : 815-728-7049
Fax Number :
Provider Business Practice Location Address
First Line : 7432 HANCOCK DR
Second Line :
City : WONDER LAKE
State : IL
Zip : 60097-9200
Country : US
Telephone Number : 815-212-5021
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2024
Last Update Date : 09/24/2024

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Directions to “ DR. CASEY DYCUS DC” Practice Location

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