Provider Demographics
NPI:1386804698
Name:CASALI, ANDREA F (LMT)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:F
Last Name:CASALI
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:F
Other - Last Name:CASALI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:2947 N 77TH AVE
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60707-1108
Mailing Address - Country:US
Mailing Address - Phone:708-456-8345
Mailing Address - Fax:708-457-1333
Practice Address - Street 1:7830 W LAWRENCE AVE
Practice Address - Street 2:
Practice Address - City:NORRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60706-3267
Practice Address - Country:US
Practice Address - Phone:708-457-8000
Practice Address - Fax:708-457-1333
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227-009310225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist