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NPI Code Detail

MEDICARE: CASSIE RENEE SEAL DPT

MEDICARE: CASSIE RENEE SEAL DPT
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
1225100000XPhysical Therapist05009964AIN

General Provider Information

NPI Number : 1144550500
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASSIE RENEE SEAL DPT
Provider Business Mailing Address
First Line : 790 REMINGTON BLVD
Second Line :
City : BOLINGBROOK
State : IL
Zip : 60440-4909
Country : US
Telephone Number : 630-296-2223
Fax Number : 630-759-9510
Provider Business Practice Location Address
First Line : 5178 FRANKLIN ST
Second Line :
City : MICHIGAN CITY
State : IN
Zip : 46360-7878
Country : US
Telephone Number : 219-879-2523
Fax Number : 219-879-5162
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2010
Last Update Date : 11/04/2016

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