Healthcare Provider Details

I. General information

NPI: 1700774585
Provider Name (Legal Business Name): OLIVIA TAYLOR LOCASCIO MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2025
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1316 SHERMAN AVE
EVANSTON IL
60201-4361
US

IV. Provider business mailing address

27W750 MACK RD
WHEATON IL
60189-3343
US

V. Phone/Fax

Practice location:
  • Phone: 847-425-9708
  • Fax:
Mailing address:
  • Phone: 630-815-8967
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: