Blue Seas Med Spa

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209015238 Issued in IL

Legal business name

BLUE SEAS MED SPA

Practice address

1220 Hobson Rd
Suite 216
Naperville, IL 60540-8139

Phone

(630) 369-2767

NPI assigned

Jan 30, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Christopher Olson, M.D.

Title

Medical Director

Phone

(630) 369-2767

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1485734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485734400000",
    "number": "1083151989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 HOBSON RD",
            "address_2": "SUITE 216",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605408139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 HOBSON RD",
            "address_2": "SUITE 216",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605408139",
            "telephone_number": "630-369-2767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE SEAS MED SPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-30",
        "last_updated": "2017-01-30",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "630-369-2767",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209015238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Naperville, IL
• Providers in Naperville, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.