Provider Demographics
NPI:1871105080
Name:SEEBERG, EMMA EILEEN (DPT)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:EILEEN
Last Name:SEEBERG
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:866-370-8206
Mailing Address - Fax:
Practice Address - Street 1:5393 S CALLE SANTA CRUZ STE 107
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85706-3556
Practice Address - Country:US
Practice Address - Phone:520-225-0129
Practice Address - Fax:520-244-0000
Is Sole Proprietor?:No
Enumeration Date:2020-08-19
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR63738225100000X
ID6664225100000X
AZ31407225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist