Provider Demographics
NPI:1780469643
Name:CASEY, LEAH ASHLEY (RN)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:ASHLEY
Last Name:CASEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:ASHLEY
Other - Last Name:HUSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3333 GREEN BAY RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60064-3095
Mailing Address - Country:US
Mailing Address - Phone:309-642-4842
Mailing Address - Fax:
Practice Address - Street 1:3333 GREEN BAY RD
Practice Address - Street 2:
Practice Address - City:NORTH CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60064-3095
Practice Address - Country:US
Practice Address - Phone:309-642-4842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1105027-30163WC0200X
IL041481995163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine