Andrew Jacob Herse Sedlack
Student in an Organized Health Care Education/Training Program in Chicago, IL. Individual provider (NPI-1).
NPI number1831815596
StatusActive
Last updated in NPPESOct 14, 2022
Details
- NPI
- 1831815596
- Entity type
- Individual (NPI-1)
- Name
- Andrew Jacob Herse Sedlack
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 14, 2022
- Certification date
- Oct 14, 2022
- Last updated
- Oct 14, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
240 E Huron St Ste 1-200Chicago, IL 60611-2909
Phone 312-503-7975
Mailing address
240 E Huron St Ste 1-200Chicago, IL 60611-2909
Phone 312-503-7975
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