MEDICARE: ELLEN K SEDER NP

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
1	363LA2100X	Acute Care Nurse Practitioner	209-004236	IL
2	363L00000X	Nurse Practitioner	209004236	IL

General Provider Information

NPI Number	:	1851380257
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELLEN K SEDER NP

Provider Business Mailing Address
First Line	:	4440 FRANKLIN AVE
Second Line	:
City	:	WESTERN SPRINGS
State	:	IL
Zip	:	60558-1529
Country	:	US
Telephone Number	:	312-342-9530
Fax Number	:

Provider Business Practice Location Address
First Line	:	676 N SAINT CLAIR ST STE 2140
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611
Country	:	US
Telephone Number	:	312-664-5400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	07/25/2018

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