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NPI Code Detail

MEDICARE: DR. DEBRA BETH SELIP MD

MEDICARE: DR. DEBRA BETH SELIP MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12080N0001XNeonatal-Perinatal Medicine Physician036120992IL
22080N0001XNeonatal-Perinatal Medicine Physician224019MA

General Provider Information

NPI Number : 1053360974
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEBRA BETH SELIP MD
Provider Business Mailing Address
First Line : 1653 W CONGRESS PKWY
Second Line : 622 MURDOCK
City : CHICAGO
State : IL
Zip : 60612-3833
Country : US
Telephone Number : 312-942-6640
Fax Number :
Provider Business Practice Location Address
First Line : 1653 W CONGRESS PKWY
Second Line : 622 MURDOCK
City : CHICAGO
State : IL
Zip : 60612-3833
Country : US
Telephone Number : 312-942-6640
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2006
Last Update Date : 04/10/2026

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