Provider Demographics
NPI:1134598386
Name:CASEY, JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:CASEY
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 1:1515 W WALNUT ST STE 6
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62650-1157
Mailing Address - Country:US
Mailing Address - Phone:217-243-5313
Mailing Address - Fax:217-243-7608
Practice Address - Street 1:1515 W WALNUT ST STE 6
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:IL
Practice Address - Zip Code:62650-1157
Practice Address - Country:US
Practice Address - Phone:217-243-5313
Practice Address - Fax:217-243-7608
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-17
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012878111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor