Provider Demographics
NPI:1407542152
Name:SED8R INC
Entity Type:Organization
Organization Name:SED8R INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KRISTA
Authorized Official - Middle Name:
Authorized Official - Last Name:KUBIELEWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-677-4451
Mailing Address - Street 1:2523 SILVER LOCH RD
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-3607
Mailing Address - Country:US
Mailing Address - Phone:630-677-4451
Mailing Address - Fax:
Practice Address - Street 1:7620 N UNIVERSITY ST STE 101
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61614-8300
Practice Address - Country:US
Practice Address - Phone:309-550-9860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-14
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty