Provider Demographics
NPI:1083827570
Name:VOORHIS, JANA DEE
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:DEE
Last Name:VOORHIS
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 1:1101 DEKALB AVE
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:SYCAMORE
Mailing Address - State:IL
Mailing Address - Zip Code:60178-3305
Mailing Address - Country:US
Mailing Address - Phone:815-751-4756
Mailing Address - Fax:
Practice Address - Street 1:1101 DEKALB AVE
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:SYCAMORE
Practice Address - State:IL
Practice Address - Zip Code:60178-3305
Practice Address - Country:US
Practice Address - Phone:815-751-4756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2270025225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist