Provider Demographics
NPI:1164891099
Name:JANIK, MOLLY FRANKLIN (WHNP-BC)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:FRANKLIN
Last Name:JANIK
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10408 AILEEN AVE
Mailing Address - Street 2:
Mailing Address - City:MOKENA
Mailing Address - State:IL
Mailing Address - Zip Code:60448-1785
Mailing Address - Country:US
Mailing Address - Phone:708-653-2565
Mailing Address - Fax:
Practice Address - Street 1:5851 W 95TH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2362
Practice Address - Country:US
Practice Address - Phone:708-499-9800
Practice Address - Fax:708-499-6203
Is Sole Proprietor?:No
Enumeration Date:2015-09-22
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.013342363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health