Healthcare Provider Details

I. General information

NPI: 1639059967
Provider Name (Legal Business Name): KELSEY LEE SELTZ APRN, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELSEY LEE NUORALA BSN, RN

II. Dates (important events)

Enumeration Date: 09/05/2025
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 W HARRISON ST
CHICAGO IL
60607-3320
US

IV. Provider business mailing address

1660 N LA SALLE DR APT 211
CHICAGO IL
60614-6007
US

V. Phone/Fax

Practice location:
  • Phone: 312-996-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number209036451
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: