Healthcare Provider Details

I. General information

NPI: 1538251509
Provider Name (Legal Business Name): JANET PICKETT R.N., C.A.D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 LEE ST SUITE 100
DES PLAINES IL
60016-4539
US

IV. Provider business mailing address

701 LEE ST SUITE 100
DES PLAINES IL
60016-4539
US

V. Phone/Fax

Practice location:
  • Phone: 847-795-2844
  • Fax: 847-795-2847
Mailing address:
  • Phone: 847-795-2844
  • Fax: 847-795-2847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: