Provider Demographics
NPI:1316080237
Name:SELS, NATHAN (DPT)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:SELS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 16TH ST
Mailing Address - Street 2:STE T14
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1302
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1600 16TH ST
Practice Address - Street 2:STE T14
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1302
Practice Address - Country:US
Practice Address - Phone:630-572-9700
Practice Address - Fax:630-572-0706
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070014876225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist