Provider Demographics
NPI:1518205541
Name:SENIOR HEALTHCARE SOLUTIONS INC
Entity Type:Organization
Organization Name:SENIOR HEALTHCARE SOLUTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:T
Authorized Official - Last Name:O'CONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:847-951-4451
Mailing Address - Street 1:1835 ROHLWING RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:ROLLING MEADOWS
Mailing Address - State:IL
Mailing Address - Zip Code:60008-1367
Mailing Address - Country:US
Mailing Address - Phone:847-951-4451
Mailing Address - Fax:
Practice Address - Street 1:1835 ROHLWING RD
Practice Address - Street 2:SUITE A
Practice Address - City:ROLLING MEADOWS
Practice Address - State:IL
Practice Address - Zip Code:60008-1367
Practice Address - Country:US
Practice Address - Phone:847-951-4451
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-25
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILDT5938Medicare PIN
ILIL8014Medicare PIN
ILIL8015Medicare PIN
ILIL8016Medicare PIN