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Individual

CARMEN JANICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
143 S LINCOLN AVE, AURORA, IL 60505-4263
(630) 897-0091
Mailing address
1316 KENT CT, WHEATON, IL 60189-8511
(630) 784-0074

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.320025
IL
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
209.010251
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
041.320025
IL
Enumeration date
01/15/2013
Last updated
07/18/2013
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