Provider Demographics
NPI:1942326368
Name:NEIL R. SELINGER MDSC
Entity Type:Organization
Organization Name:NEIL R. SELINGER MDSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:SELINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-642-9433
Mailing Address - Street 1:333 E ONTARIO ST
Mailing Address - Street 2:APT 1601B
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4804
Mailing Address - Country:US
Mailing Address - Phone:312-642-9433
Mailing Address - Fax:
Practice Address - Street 1:333 E ONTARIO ST
Practice Address - Street 2:APT 1601B
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-4804
Practice Address - Country:US
Practice Address - Phone:312-642-9433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL36062742Medicaid
IL31601639OtherBLUE CROSS BLUE SHIELD
IL31601639OtherBLUE CROSS BLUE SHIELD