Provider Demographics
NPI:1063521672
Name:SEILER, VINCENT ELLIOT (DC)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:ELLIOT
Last Name:SEILER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:VINCENT
Other - Middle Name:E
Other - Last Name:SEILER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:1810 N DELANY RD
Mailing Address - Street 2:SUITE K
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031
Mailing Address - Country:US
Mailing Address - Phone:847-623-4100
Mailing Address - Fax:847-623-9582
Practice Address - Street 1:1810 N DELANY RD
Practice Address - Street 2:SUITE K
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031
Practice Address - Country:US
Practice Address - Phone:847-623-4100
Practice Address - Fax:847-623-9582
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL211141Medicare ID - Type UnspecifiedMEMBER K15676
U68004Medicare UPIN