Healthcare Provider Details

I. General information

NPI: 1285440040
Provider Name (Legal Business Name): VICTORIA NICHOLE SENYK FPA, APRN, AGNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2024
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 DUNDEE RD STE 412
NORTHBROOK IL
60062-2436
US

IV. Provider business mailing address

7500 W WINNEMAC AVE
HARWOOD HEIGHTS IL
60706-3408
US

V. Phone/Fax

Practice location:
  • Phone: 312-366-5219
  • Fax:
Mailing address:
  • Phone: 312-366-5219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number277.005534
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: