Individual
DR. KRISHANTHI DILRUKSHI SENEVIRATNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
415 E CONGRESS PKWY STE A, CRYSTAL LAKE, IL 60014-6248
(815) 356-7494
(815) 356-7541
Mailing address
415 E CONGRESS PKWY STE A, CRYSTAL LAKE, IL 60014-6248
(815) 356-7494
(815) 356-7541
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036124671
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0361246713
—
IL
01
—
1972814267
BCBSWI
WI
01
—
SENEVKRI
MERCYCARE INSURANCE
WI
Enumeration date
07/01/2010
Last updated
08/15/2023
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