Healthcare Provider Details

I. General information

NPI: 1386332641
Provider Name (Legal Business Name): ERICA CASEY MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2023
Last Update Date: 08/30/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6339 N BIG HOLLOW RD
PEORIA IL
61615-2907
US

IV. Provider business mailing address

6339 N BIG HOLLOW RD
PEORIA IL
61615-2907
US

V. Phone/Fax

Practice location:
  • Phone: 309-693-3315
  • Fax:
Mailing address:
  • Phone: 309-693-3315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036179106
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: