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General NPI Number Information
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NPI Number | 1053842617
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Entity Type | Individual
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Provider Name | MARY GRACE SENSENG D.O.
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Gender | Female
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Dates
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Enumeration Date | 03/24/2017
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 18200 CICERO AVE
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City | COUNTRY CLUB HILLS
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State | IL
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Zip | 60478-2911
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Country | US
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Telephone | 872-231-3162
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Fax | 702-977-1496
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Provider Business Mailing Address
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Address Line | PO BOX 74008272
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City | CHICAGO
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State | IL
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Zip | 60674-8272
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Country | US
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Telephone | 702-899-0595
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Fax | 702-977-1496
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 036156077
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License Number State | IL
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