Individual
JEFFERY A SENALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
27650 FERRY RD, SUITE 100, WARRENVILLE, IL 60555-3845
(630) 225-2663
(630) 225-2399
Mailing address
27650 FERRY RD, SUITE 100, WARRENVILLE, IL 60555-3845
(630) 225-2663
(630) 225-2399
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
036100443
IL
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
036-100443
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036100443
—
IL
01
—
206147
MEDICARE PTAN (GROUP)
IL
01
—
P01136351
RR MEDICARE
IL
Enumeration date
10/21/2005
Last updated
02/06/2015
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