Individual
LACI CHRISTINE JANKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1501 MCPHERSON AVE, MOUNT VERNON, IL 62864-2831
(618) 241-1360
(618) 241-1865
Mailing address
490 W LEBANON ST, NASHVILLE, IL 62263-1349
(618) 521-1657
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
041-398735
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041-398735
STATE OF ILLINOIS LICENSES NUMBER
IL
Enumeration date
01/25/2012
Last updated
01/05/2021
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