Provider Demographics
NPI:1871808998
Name:SEAVER, MONA S (APN, CNS)
Entity type:Individual
Prefix:
First Name:MONA
Middle Name:S
Last Name:SEAVER
Suffix:
Gender:F
Credentials:APN, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 DELNOR DR
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-4220
Mailing Address - Country:US
Mailing Address - Phone:630-307-7799
Mailing Address - Fax:630-307-2277
Practice Address - Street 1:351 DELNOR DR
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-4220
Practice Address - Country:US
Practice Address - Phone:630-307-7799
Practice Address - Fax:630-307-2277
Is Sole Proprietor?:No
Enumeration Date:2010-08-12
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209007267364SX0200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No364SX0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistOncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL206147OtherMEDICARE GROUP
ILF400454036OtherMEDICARE INDIVIDUAL
IL209-007267Medicaid