Provider Demographics
NPI:1073529210
Name:WILLIAMS, JANET L
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:L
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 DELMAR DR
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-2801
Mailing Address - Country:US
Mailing Address - Phone:630-771-1104
Mailing Address - Fax:
Practice Address - Street 1:5TH AVE AND ROOSEVELT RD
Practice Address - Street 2:HINES VAH (117-G)
Practice Address - City:HINES
Practice Address - State:IL
Practice Address - Zip Code:60141
Practice Address - Country:US
Practice Address - Phone:708-202-2287
Practice Address - Fax:708-202-2281
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant