Healthcare Provider Details

I. General information

NPI: 1619771268
Provider Name (Legal Business Name): SEAN PATRICK LENIHAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2025
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1775 DEMPSTER ST
PARK RIDGE IL
60068-1143
US

IV. Provider business mailing address

19 KINGS CROSSING CT
SAINT LOUIS MO
63129-5064
US

V. Phone/Fax

Practice location:
  • Phone: 847-723-2210
  • Fax: 847-723-3394
Mailing address:
  • Phone: 314-799-9442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number125086459
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: