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General NPI Number Information
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NPI Number | 1811639180
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Entity Type | Individual
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Provider Name | MICHELLE SEAQUIST DNP, APRN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 04/08/2022
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Last Update Date | 05/19/2023
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Provider Practice Location Address
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Address Line | 224 BROWN ST STE A
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City | WAUCONDA
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State | IL
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Zip | 60084-1747
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Country | US
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Telephone | 847-795-3350
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Fax | 847-487-2841
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Provider Business Mailing Address
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Address Line | 29373 NETWORK PL
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City | CHICAGO
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State | IL
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Zip | 60673-1293
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Country | US
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Telephone | 847-390-5900
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Fax | 847-390-4757
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 041435035
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209026314
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License Number State | IL
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