1497731897 NPI number — DR. LYNNE K JANSKY CNS APN

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497731897 NPI number — DR. LYNNE K JANSKY CNS APN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JANSKY
Provider First Name:
LYNNE
Provider Middle Name:
K
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
CNS APN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
POSHEPNY
Provider Other First Name:
LYNNE
Provider Other Middle Name:
K
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN MSN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1497731897
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/16/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

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

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
151 N MICHIGAN AVE
Provider Second Line Business Practice Location Address:
STE 656
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60601-7506
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-330-3323
Provider Business Practice Location Address Fax Number:
312-729-5082
Provider Enumeration Date:
12/16/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 364S00000X , with the licence number:  209003193 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1619761 . This is a "BLUE CROSS SHIELD" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 056797 . This is a "VALUE OPTIONS" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




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