Provider Demographics
NPI:1881206498
Name:SENJANOVICH, ANTOINETTE LYNN (MSW)
Entity Type:Individual
Prefix:
First Name:ANTOINETTE
Middle Name:LYNN
Last Name:SENJANOVICH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5750 N KENMORE AVE APT 207
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-4529
Mailing Address - Country:US
Mailing Address - Phone:224-607-4528
Mailing Address - Fax:
Practice Address - Street 1:5750 N KENMORE AVE APT 207
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60660-4529
Practice Address - Country:US
Practice Address - Phone:224-607-4528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150104489104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker