Provider Demographics
NPI:1073922019
Name:CASEY, NATALIE RENEE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:RENEE
Last Name:CASEY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:RENEE
Other - Last Name:HACKETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1546 WATER ST
Mailing Address - Street 2:
Mailing Address - City:BLUE ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:60406-5094
Mailing Address - Country:US
Mailing Address - Phone:815-370-4581
Mailing Address - Fax:
Practice Address - Street 1:1546 WATER ST
Practice Address - Street 2:
Practice Address - City:BLUE ISLAND
Practice Address - State:IL
Practice Address - Zip Code:60406-5094
Practice Address - Country:US
Practice Address - Phone:815-370-4581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-04
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070017242225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist