Individual provider Active NPI

Daniel Mendoza Senseng, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1578598157
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036075949 Issued in IL
Practice address
2545 S King Dr
Chicago, IL 60616-2441
Phone
(312) 842-7117
Fax
(312) 949-1895
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036075949 IL Primary

Addresses

Primary practice location

2545 S King Dr
Chicago, IL 60616-2441

Mailing address

2545 S King Dr
Chicago, IL 60616-2441
Phone (708) 383-8418

Other identifiers 1

IdentifierTypeStateIssuer
036075949MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address dsenseng205887@direct.myadvocateaurora.org Direct
FHIR URL dsenseng205887@direct.myadvocateaurora.org

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
I20100304000359 IL Practitioner - Internal MedicinePractitioner - Endocrinology 9739224528

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036075949ILMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1578598157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2545 S KING DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162441",
            "telephone_number": "708-383-8418",
            "fax_number": "312-949-1895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 S KING DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162441",
            "telephone_number": "312-842-7117",
            "fax_number": "312-949-1895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SENSENG",
        "first_name": "DANIEL",
        "middle_name": "MENDOZA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036075949",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036075949",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dsenseng205887@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2545 S King Dr",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606162441",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "dsenseng205887@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "2545 S King Dr",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606162441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.