MEDICARE: SUSAN MICHELLE HENSEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	225100000X	OTHER	IL	PT
2	1699094102	OTHER	IL	COMPREHENSIVE THERAPEURICS

General Provider Information

NPI Number	:	1285354225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN MICHELLE HENSEY

Provider Business Mailing Address
First Line	:	4817 OAK HILL RD
Second Line	:
City	:	ROCHESTER
State	:	IL
Zip	:	62563-6213
Country	:	US
Telephone Number	:	217-341-6933
Fax Number	:

Provider Business Practice Location Address
First Line	:	4817 OAK HILL RD
Second Line	:
City	:	ROCHESTER
State	:	IL
Zip	:	62563-6213
Country	:	US
Telephone Number	:	217-341-6932
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2022
Last Update Date	:	08/30/2022

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Directions to “ SUSAN MICHELLE HENSEY ” Practice Location

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