Provider Demographics
NPI:1760946818
Name:STURMON, CASEY LYNN
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:LYNN
Last Name:STURMON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 HONEYTREE DR
Mailing Address - Street 2:
Mailing Address - City:ROMEOVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60446-4075
Mailing Address - Country:US
Mailing Address - Phone:815-258-9222
Mailing Address - Fax:
Practice Address - Street 1:706 HONEYTREE DR
Practice Address - Street 2:
Practice Address - City:ROMEOVILLE
Practice Address - State:IL
Practice Address - Zip Code:60446-4075
Practice Address - Country:US
Practice Address - Phone:815-258-9222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer