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Individual

NATHANIEL EDWARD SEVILLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MAED, ATC/L

Contact information

Practice address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2222
(205) 482-3605
Mailing address
517 LIVINGSTON DR, NEW LENOX, IL 60451-1626
(708) 250-3272

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.002404
IL

Other

Enumeration date
08/03/2006
Last updated
02/03/2015
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