Active NPI
Alicia Renee' Case
- Psychologist
- Great Lakes, IL
National Provider Identifier
1982721585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 3001 A 6TH Street
Great Lakes, IL 60088 - Phone
- (847) 688-7406
- Fax
- (847) 688-7403
- NPI assigned
- Mar 26, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | IL | Primary |
Addresses
Primary practice location
3001 A 6TH Street
Great Lakes, IL 60088
Mailing address
3308 Harbor Ridge Drive
Zion, IL 60099-9999
Phone (847) 688-7406
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 390200000X | IL | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1982721585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3308 HARBOR RIDGE DRIVE",
"city": "ZION",
"state": "IL",
"postal_code": "600999999",
"telephone_number": "847-688-7406",
"fax_number": "847-688-7403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3001 A 6TH STREET",
"city": "GREAT LAKES",
"state": "IL",
"postal_code": "60088",
"telephone_number": "847-688-7406",
"fax_number": "847-688-7403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASE",
"first_name": "ALICIA",
"middle_name": "RENEE'",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Great Lakes, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.