Provider Demographics
NPI:1083499370
Name:JARKA, JUDITH DOROTHY (MS)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:DOROTHY
Last Name:JARKA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2644 N 3739TH RD
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:IL
Mailing Address - Zip Code:60551-9408
Mailing Address - Country:US
Mailing Address - Phone:773-966-8235
Mailing Address - Fax:
Practice Address - Street 1:2644 N 3739TH RD
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:IL
Practice Address - Zip Code:60551-9408
Practice Address - Country:US
Practice Address - Phone:773-966-8235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242.007290235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist