Individual provider Active NPI

Ricardo Gabriel Senno, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Northbrook, IL
National Provider Identifier
1326116104
Registry record updated May 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
036099306 Issued in IL
Practice address
1535 Lake Cook Rd
Suite 306
Northbrook, IL 60062-1447
Phone
(847) 644-8242
Fax
(847) 272-8221
NPI assigned
Dec 1, 2006
Last updated
May 2, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 036099306 IL Primary

Addresses

Primary practice location

1535 Lake Cook Rd
Suite 306
Northbrook, IL 60062-1447

Mailing address

1535 Lake Cook Rd
Suite 306
Northbrook, IL 60062-1447
Phone (847) 644-8242

Other identifiers 2

IdentifierTypeStateIssuer
036099306MedicaidIL
363236791OtherILTAX ID #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050906000895 IL Practitioner - Physical Medicine and Rehabilitation 5395777817

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1535 Lake Cook Rd
Suite 306
Northbrook, IL 60062-1447

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Sennogroup, SC Physical Medicine & Rehabilitation CurrentSince Jun 11, 2008 Accepting new patients
Integrative Rehabmedicine SC Past Accepting new patients

Locations

5501 W 79th St
Burbank, IL 60459
Phone (708) 296-0852

5501 W 79th St
Ste 400
Burbank, IL 60459

751 E Terra Cotta Ave
Crystal Lake, IL 60014
Phone (224) 353-6361

1535 Lake Cook Rd
Ste 306
Northbrook, IL 60062
Phone (224) 522-6550

910 Skokie Blvd
Ste 201
Northbrook, IL 60062
Phone (212) 920-6357

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493683200000",
    "number": "1326116104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1535 LAKE COOK RD",
            "address_2": "SUITE 306",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621447",
            "telephone_number": "847-644-8242",
            "fax_number": "847-272-8221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 LAKE COOK RD",
            "address_2": "SUITE 306",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621447",
            "telephone_number": "847-644-8242",
            "fax_number": "847-272-8221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SENNO",
        "first_name": "RICARDO",
        "middle_name": "GABRIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2017-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "036099306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036099306",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "363236791",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

Verify at the official NPI Registry.