Provider Demographics
NPI:1043409360
Name:SELINGER, NEIL ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:ROBERT
Last Name:SELINGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 E ONTARIO ST APT 1601B
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4870
Mailing Address - Country:US
Mailing Address - Phone:312-642-9433
Mailing Address - Fax:
Practice Address - Street 1:333 E ONTARIO ST APT 1601B
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-4870
Practice Address - Country:US
Practice Address - Phone:312-642-9433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL36062742Medicaid
IL678440Medicare PIN