Provider Demographics
NPI:1962526319
Name:SENKPEIL, EDWARD WALTER (M A)
Entity type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:WALTER
Last Name:SENKPEIL
Suffix:
Gender:M
Credentials:M A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2214 LOTUS DR
Mailing Address - Street 2:
Mailing Address - City:ROUND LAKE HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60073-1170
Mailing Address - Country:US
Mailing Address - Phone:847-740-6908
Mailing Address - Fax:
Practice Address - Street 1:318 W HALF DAY RD PMB 284
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-6547
Practice Address - Country:US
Practice Address - Phone:847-821-9346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health