Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 5665 | MN |
N | 111NR0200X | Radiology | 038012287 | IL |
N | 213ER0200X | Radiology | 038012287 | IL |
NPI | 1265790992 |
---|---|
Provider Name | Dr. Andrew Bryan Seppala |
First Address | North Aurora, IL 60542-4604 |
Second Address | North Aurora, IL 60542-4604 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2012 |
Last Update Date | 14/04/2016 |