Basic Information
| Provider Information | |||||||||
| NPI: | 1811153034 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SEBA | ||||||||
| FirstName: | AMBER | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 62647 COLLECTION CENTER DR | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606930626 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9139613649 | ||||||||
| FaxNumber: | 7084248904 | ||||||||
| Practice Location | |||||||||
| Address1: | 1800 HOLLISTER DR STE 112 | ||||||||
| Address2: | |||||||||
| City: | LIBERTYVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600485265 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8473676781 | ||||||||
| FaxNumber: | 8473678008 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/07/2008 | ||||||||
| LastUpdateDate: | 12/16/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 125053611 | IL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RH0003X | 036.125410 | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
No ID Information.