Provider Demographics
NPI:1518009885
Name:SEEZOX, JONATHAN (DC)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:
Last Name:SEEZOX
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 CARLEMONT DR
Mailing Address - Street 2:SUITE M
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-1833
Mailing Address - Country:US
Mailing Address - Phone:815-444-1636
Mailing Address - Fax:312-928-0682
Practice Address - Street 1:1500 CARLEMONT DR
Practice Address - Street 2:SUITE M
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-1833
Practice Address - Country:US
Practice Address - Phone:815-444-1636
Practice Address - Fax:312-928-0682
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILU92828Medicare UPIN
IL203464Medicare ID - Type Unspecified