Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | IL |
NPI | 1043268329 |
---|---|
Provider Name | Robert M Seo |
First Address | Naperville, IL 60540-8904 |
Second Address | Naperville, IL 60540-8904 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G82174 | (02) |