Individual
JACK G CASINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1801 S HIGHLAND AVE, STE 220, LOMBARD, IL 60148-4932
(630) 873-8700
Mailing address
1860 PAYSPHERE CIR, CHICAGO, IL 60674-0018
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
036063475
IL
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
036063475
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036063475
—
IL
Enumeration date
11/16/2005
Last updated
01/20/2011
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