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1770591919
NATHANIEL EDWARD SEVILLE
BOLINGBROOK, IL
NPI
1770591919
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
(Licence: IL 096.002404)
Enumeration Date
2006-08-03
Last Update Date
2015-02-03
Business Address
NATHANIEL EDWARD SEVILLE MAED, ATC/L
790 REMINGTON BLVD
BOLINGBROOK, IL 60440-4909
Phone number: 630-296-2222
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Mailing Address
NATHANIEL EDWARD SEVILLE MAED, ATC/L
517 LIVINGSTON DR
NEW LENOX, IL 60451-1626
Phone number: 708-250-3272
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