Healthcare Provider Details

I. General information

NPI: 1568667582
Provider Name (Legal Business Name): JANUSZ MEJER MD, SC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 E NORTHWEST HWY
MT PROSPECT IL
60056-3464
US

IV. Provider business mailing address

770 E NORTHWEST HWY
MT PROSPECT IL
60056-3464
US

V. Phone/Fax

Practice location:
  • Phone: 312-375-2942
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number StateIL

VIII. Authorized Official

Name: ANETA PEREZ
Title or Position: MANAGER
Credential:
Phone: 847-444-0553