Provider Demographics
NPI:1407296502
Name:SETO, ERIC (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:SETO
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 W HARRISON ST UNIT 1007
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-1080
Mailing Address - Country:US
Mailing Address - Phone:312-281-8874
Mailing Address - Fax:
Practice Address - Street 1:180 N MICHIGAN AVE STE 1025G
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7999
Practice Address - Country:US
Practice Address - Phone:312-281-8874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-03
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.008273103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical