Healthcare Provider Details

I. General information

NPI: 1578058640
Provider Name (Legal Business Name): CASEY EVANGELINE GRAFF MSN, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2018
Last Update Date: 06/13/2022
Certification Date: 06/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 OGDEN AVE
AURORA IL
60504-7222
US

IV. Provider business mailing address

2000 OGDEN AVE
AURORA IL
60504-7222
US

V. Phone/Fax

Practice location:
  • Phone: 866-565-8607
  • Fax: 630-898-3427
Mailing address:
  • Phone: 866-565-8607
  • Fax: 630-898-3427

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209017459
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: