Provider Demographics
NPI:1427765577
Name:JANUSZKA, JENNA ELIZABETH (PHARMD)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:ELIZABETH
Last Name:JANUSZKA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 S WOOD ST STE 105
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-7229
Mailing Address - Country:US
Mailing Address - Phone:312-355-4888
Mailing Address - Fax:
Practice Address - Street 1:833 S WOOD ST STE 105
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-7229
Practice Address - Country:US
Practice Address - Phone:312-355-4888
Practice Address - Fax:747-215-5579
Is Sole Proprietor?:No
Enumeration Date:2022-10-28
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0513040171835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care