Basic Information
| Provider Information | |||||||||
| NPI: | 1548683907 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SEDER | ||||||||
| FirstName: | BREA | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20 N CLARK ST | ||||||||
| Address2: | SUITE 2650 | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606024109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8662965262 | ||||||||
| FaxNumber: | 3125581570 | ||||||||
| Practice Location | |||||||||
| Address1: | 2625 BUTTERFIELD RD | ||||||||
| Address2: | SUITE 101N | ||||||||
| City: | OAK BROOK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605231234 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8662965262 | ||||||||
| FaxNumber: | 6305714640 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/21/2014 | ||||||||
| LastUpdateDate: | 01/21/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 149015875 | IL | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.