Healthcare Provider Details

I. General information

NPI: 1134051311
Provider Name (Legal Business Name): ASHLEY MICHELLE CACERES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3320 LINCOLN ST
FRANKLIN PARK IL
60131-1514
US

IV. Provider business mailing address

221 S UNION ST
ALEXANDRIA VA
22314-3325
US

V. Phone/Fax

Practice location:
  • Phone: 773-377-5492
  • Fax:
Mailing address:
  • Phone: 773-377-5492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: