Provider Demographics
NPI:1952667982
Name:CASINI, REBECCA ANNE (DO)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:ANNE
Last Name:CASINI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:REBECCA
Other - Middle Name:ANNE
Other - Last Name:PETROSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1000 CENTRAL ST STE 800
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1780
Mailing Address - Country:US
Mailing Address - Phone:847-570-1795
Mailing Address - Fax:847-503-4590
Practice Address - Street 1:1000 CENTRAL ST STE 800
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201
Practice Address - Country:US
Practice Address - Phone:847-570-1795
Practice Address - Fax:847-503-4590
Is Sole Proprietor?:No
Enumeration Date:2012-04-03
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036147040208000000X
IL036.1470402080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics