Healthcare Provider Details
I. General information
NPI: 1528144797
Provider Name (Legal Business Name): NEW FOCUS HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/31/2006
Last Update Date: 08/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
151 N MICHIGAN AVE STE 1014
CHICAGO IL
60601-7538
US
IV. Provider business mailing address
PO BOX 148147
CHICAGO IL
60614-8147
US
V. Phone/Fax
- Phone: 312-330-3323
- Fax: 312-819-0170
- Phone: 312-330-3323
- Fax: 312-819-0170
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 036076701 |
| License Number State | IL |
VIII. Authorized Official
Name: DR.
LYNNE
K
JANJKY
Title or Position: OWNER
Credential: CLINICAL NURSE SPECI
Phone: 312-330-3323