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General NPI Number Information
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NPI Number | 1124572664
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Entity Type | Individual
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Provider Name | CASEY VOGEL PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 08/13/2016
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Last Update Date | 08/13/2016
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Provider Practice Location Address
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Address Line | 225 E CHICAGO AVE # 142
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City | CHICAGO
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State | IL
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Zip | 60611-2991
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Country | US
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Telephone | 414-617-3350
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Fax |
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Provider Business Mailing Address
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Address Line | 681 1/2 W WRIGHTWOOD AVE APT 2W
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City | CHICAGO
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State | IL
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Zip | 60614-2526
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070.021057
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License Number State | IL
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