Provider Demographics
NPI:1164519930
Name:SENAPATI, SANGEETA (MD)
Entity Type:Individual
Prefix:
First Name:SANGEETA
Middle Name:
Last Name:SENAPATI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9650 GROSS POINT RD STE 3900
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1214
Mailing Address - Country:US
Mailing Address - Phone:847-926-6544
Mailing Address - Fax:847-926-6545
Practice Address - Street 1:9650 GROSS POINT RD STE 3900
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076
Practice Address - Country:US
Practice Address - Phone:847-926-6544
Practice Address - Fax:847-926-6545
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036117921207VG0400X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4779043Medicaid
MI0H16063142Medicare ID - Type Unspecified
MI4779043Medicaid