Provider Demographics
NPI:1164864591
Name:CUMMINGS, CASEY MAUREEN (AUD)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:MAUREEN
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 SPRINGLAKE LN
Mailing Address - Street 2:APT C
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-4026
Mailing Address - Country:US
Mailing Address - Phone:630-341-3040
Mailing Address - Fax:
Practice Address - Street 1:637 W STATE ST
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-2159
Practice Address - Country:US
Practice Address - Phone:630-232-9153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-26
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147001465231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist