Provider Demographics
NPI:1609810001
Name:MCGUIRE, CASEY TOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:CASEY
Middle Name:TOMAS
Last Name:MCGUIRE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18663 W WESTWOOD PL
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-1376
Mailing Address - Country:US
Mailing Address - Phone:608-469-6800
Mailing Address - Fax:
Practice Address - Street 1:2521 WAUKEGAN RD
Practice Address - Street 2:
Practice Address - City:BANNOCKBURN
Practice Address - State:IL
Practice Address - Zip Code:60015-1569
Practice Address - Country:US
Practice Address - Phone:847-267-0778
Practice Address - Fax:847-267-0668
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4196-012111N00000X
IL038011540111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI204981962OtherEIN