Individual provider Active NPI

Maxime R Senecal

  • Physical Therapy Assistant
  • Chicago, IL
National Provider Identifier
1750608089
Registry record updated Apr 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
160000877 Issued in IL
Practice address
222 S Riverside PLZ
Chicago, IL 60606-5808
Phone
(312) 416-3804
NPI assigned
Apr 26, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 160000877 IL Primary

Addresses

Primary practice location

222 S Riverside PLZ
Chicago, IL 60606-5808

Mailing address

918 S Humphrey Ave
Oak Park, IL 60304-1721

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
160000877ILMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1272240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272240000000",
    "number": "1750608089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "918 S HUMPHREY AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603041721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S RIVERSIDE PLZ",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606065808",
            "telephone_number": "312-416-3804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SENECAL",
        "first_name": "MAXIME",
        "middle_name": "R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-26",
        "last_updated": "2010-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160000877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.