Active NPI
Nathaniel Edward Seville, MAED, ATC/L
- Athletic Trainer
- Bolingbrook, IL
National Provider Identifier
1770591919
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 096.002404
- Practice address
- 790 Remington Blvd
Bolingbrook, IL 60440-4909 - Phone
- (630) 296-2222
- Fax
- (205) 482-3605
- NPI assigned
- Aug 3, 2006
- Last updated
- Feb 3, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 096.002404 | IL | Primary |
Addresses
Primary practice location
790 Remington Blvd
Bolingbrook, IL 60440-4909
Mailing address
517 Livingston Dr
New Lenox, IL 60451-1626
Phone (708) 250-3272
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 096.002404 | IL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422921600000",
"number": "1770591919",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "517 LIVINGSTON DR",
"city": "NEW LENOX",
"state": "IL",
"postal_code": "604511626",
"telephone_number": "708-250-3272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909",
"telephone_number": "630-296-2222",
"fax_number": "205-482-3605"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEVILLE",
"first_name": "NATHANIEL",
"middle_name": "EDWARD",
"credential": "MAED, ATC/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-03",
"last_updated": "2015-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": "096.002404",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bolingbrook, IL
- Senior Estates Supportive Living Facility Limited Partnership (Heritage Woods of Bolingbrook)
- Marielle B Serenda, OD
- Serenity Signature Health LLC
- Servant's Heart Home Care, LLC
- Laura McDaniel Setlur, M.D
- Shamil Shafi, DMD
- Shane Shafi, DMD
- Kinjal U. Shah, M.D.
- Surbhi Parth Shah, MD
- Syed Muhammad Shahabuddin, DDS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.