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General NPI Number Information
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NPI Number | 1346303179
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Entity Type | Individual
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Provider Name | KATHLEEN L JANSSEN O.D.
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Gender | Female
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2 HAWTHORN CTR
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City | VERNON HILLS
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State | IL
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Zip | 60061-1520
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Country | US
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Telephone | 847-367-0885
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Fax | 847-367-0394
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Provider Business Mailing Address
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Address Line | 818 BELINDER LN APT 2003
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City | SCHAUMBURG
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State | IL
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Zip | 60173-5280
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Country | US
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Telephone | 773-501-0104
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Fax | 847-367-0394
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State | IL
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