Provider Demographics
NPI:1225413214
Name:DR. SCOTT SELBY, LLC
Entity Type:Organization
Organization Name:DR. SCOTT SELBY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:SELBY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-781-6697
Mailing Address - Street 1:207 N WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-5314
Mailing Address - Country:US
Mailing Address - Phone:630-781-6697
Mailing Address - Fax:
Practice Address - Street 1:207 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-5314
Practice Address - Country:US
Practice Address - Phone:630-781-6697
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-20
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038007807111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty