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General NPI Number Information
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NPI Number | 1629088489
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Entity Type | Individual
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Provider Name | DENISE CASEY PSYD
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Gender | Female
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1610 LUTHER LN
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City | PARK RIDGE
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State | IL
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Zip | 60068-1243
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Country | US
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Telephone | 847-795-3143
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Fax | 847-823-9222
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Provider Business Mailing Address
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Address Line | 432 BROOKMONT LN
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City | NORTH BARRINGTON
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State | IL
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Zip | 60010-2106
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Country | US
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Telephone | 847-382-6393
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071-005803
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License Number State | IL
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