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General NPI Number Information
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NPI Number | 1891098539
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Entity Type | Individual
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Provider Name | JANET MARIE O'CONNELL M.S., L.M.F.T.
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Gender | Female
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Dates
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Enumeration Date | 12/20/2010
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Last Update Date | 12/11/2012
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Provider Practice Location Address
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Address Line | 4186 N PERRYVILLE RD
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City | LOVES PARK
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State | IL
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Zip | 61111-8647
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Country | US
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Telephone | 779-771-2614
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Fax | 888-492-3820
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Provider Business Mailing Address
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Address Line | 4186 N PERRYVILLE RD
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City | LOVES PARK
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State | IL
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Zip | 61111-8647
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Country | US
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Telephone | 779-771-2614
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Fax | 888-492-3820
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 166.000817
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License Number State | IL
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