Healthcare Provider Details

I. General information

NPI: 1336949551
Provider Name (Legal Business Name): DANIEL KACEY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2025
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1853 W POLK ST
CHICAGO IL
60612-4355
US

IV. Provider business mailing address

124 N BRUNER ST
HINSDALE IL
60521-3023
US

V. Phone/Fax

Practice location:
  • Phone: 312-996-3500
  • Fax:
Mailing address:
  • Phone: 630-408-2916
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number125.088046
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: