Individual
JOHN R SELLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1701 W CURTIS ROAD, FAMILY MEDICINE/CONVENIENT CARE, CHAMPAIGN, IL 61822
(217) 365-6201
(217) 326-1234
Mailing address
611 W. PARK. ST., BWPC, URBANA, IL 61801-2500
(217) 383-6792
(217) 383-4752
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036081168
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0533210001
DMERC
IL
01
—
080043875
RAILROAD
IL
Enumeration date
09/25/2006
Last updated
05/12/2014
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