Healthcare Provider Details

I. General information

NPI: 1154685303
Provider Name (Legal Business Name): ERIN ELIZABETH CASEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2012
Last Update Date: 04/18/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 GARVEY PKWY
SAINT CHARLES MO
63303-5614
US

IV. Provider business mailing address

PO BOX 7412031
CHICAGO IL
60674-2031
US

V. Phone/Fax

Practice location:
  • Phone: 636-441-7280
  • Fax: 636-939-9208
Mailing address:
  • Phone: 636-441-7280
  • Fax: 636-939-9208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2015027598
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: