Individual
MRS. JANINE ROSE SULAVIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
275 JOLIET ST, DYER, IN 46311-1776
(219) 865-8800
Mailing address
5141 VIRGINIA WAY STE 350, BRENTWOOD, TN 37027-2319
(615) 449-5771
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085007718
IL
363A00000X
Physician Assistant
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/20/2020
Last updated
01/14/2025
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