Antonio Senat MD LTD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

036047085 Issued in IL

Legal business name

ANTONIO SENAT MD LTD

Practice address

2201 W Roosevelt Rd
Broadview, IL 60155-3812

Phone

(708) 343-5773

Fax

(708) 343-2649

NPI assigned

May 21, 2007

Organization subpart

No

Name

Diana Polyakov

Title

Billing Manager

Phone

(847) 897-5995

Locations

• antonio senat md ltd Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 18, 2010.

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263772800000",
    "number": "1124237045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 W ROOSEVELT RD",
            "city": "BROADVIEW",
            "state": "IL",
            "postal_code": "601553812",
            "telephone_number": "708-343-5773",
            "fax_number": "708-343-2649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 W ROOSEVELT RD",
            "city": "BROADVIEW",
            "state": "IL",
            "postal_code": "601553812",
            "telephone_number": "708-343-5773",
            "fax_number": "708-343-2649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTONIO SENAT MD LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2010-01-18",
        "status": "A",
        "authorized_official_last_name": "POLYAKOV",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "847-897-5995"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036047085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036047085",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "antonio senat md ltd",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Broadview, IL
• Cardiovascular Disease Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.