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General NPI Number Information
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NPI Number | 1073700688
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Entity Type | Organization
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Legal Business Name | GERTA JANSS, MD, S.C.
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Dates
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Enumeration Date | 09/27/2007
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Last Update Date | 03/01/2012
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Provider Practice Location Address
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Address Line | 711 11TH ST
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City | WILMETTE
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State | IL
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Zip | 60091-2662
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Country | US
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Telephone | 847-920-0225
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Fax |
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Provider Business Mailing Address
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Address Line | 711 11TH ST
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City | WILMETTE
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State | IL
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Zip | 60091-2662
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GERTA JANSS
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Credential | MD
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Telephone | 847-920-0225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 036080132
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License Number State | IL
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