Organization
ANTONIO SENAT MD LTD
Active
Other names
antonio senat md ltd
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA POLYAKOV (BILLING MANAGER)
(847) 897-5995
Entity
Organization
Contact information
Practice address
2201 W ROOSEVELT RD, BROADVIEW, IL 60155-3812
(708) 343-5773
(708) 343-2649
Mailing address
2201 W ROOSEVELT RD, BROADVIEW, IL 60155-3812
(708) 343-5773
(708) 343-2649
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036047085
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036047085
—
IL
Enumeration date
05/21/2007
Last updated
01/18/2010
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