MEDICARE: ANTHONY JOSEPH CASEY LCPC, NCC

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	101YM0800X	Mental Health Counselor	180.016875	IL

General Provider Information

NPI Number	:	1588416275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY JOSEPH CASEY LCPC, NCC

Provider Business Mailing Address
First Line	:	4603 N RACINE AVE APT 204
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-6387
Country	:	US
Telephone Number	:	224-598-6453
Fax Number	:	773-961-7375

Provider Business Practice Location Address
First Line	:	6200 N HIAWATHA AVE STE 450
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60646-4316
Country	:	US
Telephone Number	:	773-999-1756
Fax Number	:	773-262-4841

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

Provider Enumeration Date	:	04/04/2024
Last Update Date	:	12/16/2025

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