Provider Demographics
NPI:1063593721
Name:CASACCIO, GARY A (MD)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:A
Last Name:CASACCIO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2100 MANCHESTER RD
Mailing Address - Street 2:SUITE 1510
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-4579
Mailing Address - Country:US
Mailing Address - Phone:630-653-1717
Mailing Address - Fax:630-653-9691
Practice Address - Street 1:2100 MANCHESTER RD
Practice Address - Street 2:SUITE 1510
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-4579
Practice Address - Country:US
Practice Address - Phone:630-653-1717
Practice Address - Fax:630-653-9691
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2011-08-18
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Provider Licenses
StateLicense IDTaxonomies
IL036-0895442084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry