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General NPI Number Information
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NPI Number | 1578143459
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Entity Type | Individual
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Provider Name | HAILEY SELLEK
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Gender | Female
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Dates
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Enumeration Date | 04/13/2021
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 8914 N KNOXVILLE AVE
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City | PEORIA
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State | IL
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Zip | 61615-1410
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Country | US
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Telephone | 309-691-9110
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 135
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City | PECATONICA
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State | IL
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Zip | 61063-0135
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Country | US
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Telephone | 217-249-1077
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 103031-875
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036.167759
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License Number State | IL
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