Provider Demographics
NPI:1841282795
Name:VANSENUS, TAMI SUE (DC)
Entity type:Individual
Prefix:DR
First Name:TAMI
Middle Name:SUE
Last Name:VANSENUS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 SOUTH RT 41
Mailing Address - Street 2:SUITE B
Mailing Address - City:SCHERERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46375
Mailing Address - Country:US
Mailing Address - Phone:219-322-2204
Mailing Address - Fax:219-322-7539
Practice Address - Street 1:221 SOUTH RT 41
Practice Address - Street 2:SUITE B
Practice Address - City:SCHERERVILLE
Practice Address - State:IN
Practice Address - Zip Code:46375
Practice Address - Country:US
Practice Address - Phone:219-322-2204
Practice Address - Fax:219-322-7539
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001850A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN350054013OtherRR MEDICARE
7885269OtherAETNA
2680967OtherAETNA HMO
IN200350050AMedicaid
5292004OtherBCE EMERGIS
623628OtherACN
IN000000207533OtherBLUE SHIELD
IN000000207533OtherBLUE SHIELD
IN185480Medicare PIN