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General NPI Number Information
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NPI Number | 1871378018
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Entity Type | Individual
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Provider Name | JESSICA C CASEY PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/28/2023
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Last Update Date | 08/28/2023
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Provider Practice Location Address
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Address Line | 4580 WEAVER PKWY STE 102
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City | WARRENVILLE
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State | IL
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Zip | 60555-3864
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Country | US
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Telephone | 630-839-9199
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Fax | 630-839-9299
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Provider Business Mailing Address
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Address Line | 1647 CASTBOURNE CT
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City | WHEATON
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State | IL
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Zip | 60189-7001
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Country | US
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Telephone | 708-625-4871
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 209027898
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License Number State | IL
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