MEDICARE: MS. VICTORIA NICHOLE SENYK APRN, AGNP-C

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	363LG0600X	Gerontology Nurse Practitioner	209.030502	IL

General Provider Information

NPI Number	:	1285440040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VICTORIA NICHOLE SENYK APRN, AGNP-C

Provider Business Mailing Address
First Line	:	7500 W WINNEMAC AVE
Second Line	:
City	:	HARWOOD HEIGHTS
State	:	IL
Zip	:	60706-3408
Country	:	US
Telephone Number	:	312-366-5219
Fax Number	:

Provider Business Practice Location Address
First Line	:	7500 W WINNEMAC AVE
Second Line	:
City	:	HARWOOD HEIGHTS
State	:	IL
Zip	:	60706-3408
Country	:	US
Telephone Number	:	312-366-5219
Fax Number	:

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

Provider Enumeration Date	:	12/06/2024
Last Update Date	:	12/06/2024

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