MEDICARE: DR. LYNNE K JANSKY CNS APN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	364S00000X	Clinical Nurse Specialist	209003193	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1619761	OTHER	IL	BLUE CROSS SHIELD
2	056797	OTHER	IL	VALUE OPTIONS

General Provider Information

NPI Number	:	1497731897
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LYNNE K JANSKY CNS APN

Provider Business Mailing Address
First Line	:	PO BOX 148147
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-8147
Country	:	US
Telephone Number	:	312-330-3323
Fax Number	:	312-819-0170

Provider Business Practice Location Address
First Line	:	151 N MICHIGAN AVE
Second Line	:	STE 656
City	:	CHICAGO
State	:	IL
Zip	:	60601-7506
Country	:	US
Telephone Number	:	312-330-3323
Fax Number	:	312-729-5082

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/16/2005
Last Update Date	:	11/16/2011

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