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General NPI Number Information
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NPI Number | 1023783800
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Entity Type | Individual
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Provider Name | JANIS PARKER MA
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Gender | Female
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Dates
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Enumeration Date | 08/12/2021
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Last Update Date | 08/12/2021
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Provider Practice Location Address
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Address Line | 5756 N RIDGE AVE STE 9
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City | CHICAGO
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State | IL
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Zip | 60660-5332
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Country | US
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Telephone | 773-657-4142
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Fax |
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Provider Business Mailing Address
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Address Line | 7415 N PAULINA ST APT 3
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City | CHICAGO
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State | IL
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Zip | 60626-1896
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Country | US
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Telephone | 479-462-9133
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 178.017051
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License Number State | IL
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