Individual
MRS. KATHY ANN JANUARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2364 DELAWARE AVE, APT A, GREAT LAKES, IL 60088-2532
(847) 508-1799
Mailing address
2364 DELAWARE AVE, APT A, GREAT LAKES, IL 60088-2532
(847) 508-1799
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
Primary
041-275899
IL
Other
Enumeration date
07/19/2006
Last updated
08/29/2012
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