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NPI Code Detail

MEDICARE: ANNA JANKOWSKA MA LCPC CEAP SAP

MEDICARE:   ANNA  JANKOWSKA  MA LCPC CEAP SAP
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
1101YA0400XAddiction (Substance Use Disorder) Counselor15116IL
2101YM0800XMental Health Counselor180-005383IL

General Provider Information

NPI Number : 1598843526
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNA JANKOWSKA MA LCPC CEAP SAP
Provider Business Mailing Address
First Line : 4515 N MILWAUKEE
Second Line :
City : CHICAGO
State : IL
Zip : 60630
Country : US
Telephone Number : 773-777-6767
Fax Number : 773-777-7274
Provider Business Practice Location Address
First Line : 4515 N MILWAUKEE
Second Line :
City : CHICAGO
State : IL
Zip : 60630
Country : US
Telephone Number : 773-777-6767
Fax Number : 773-777-7274
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 06/28/2013

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