Provider Demographics
NPI:1194860106
Name:BIEDRON, JANET (APN)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:BIEDRON
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 RIVER OAKS DR
Mailing Address - Street 2:
Mailing Address - City:CALUMET CITY
Mailing Address - State:IL
Mailing Address - Zip Code:60409-5802
Mailing Address - Country:US
Mailing Address - Phone:708-862-1290
Mailing Address - Fax:708-862-6447
Practice Address - Street 1:19 RIVER OAKS DR
Practice Address - Street 2:
Practice Address - City:CALUMET CITY
Practice Address - State:IL
Practice Address - Zip Code:60409-5802
Practice Address - Country:US
Practice Address - Phone:708-862-1290
Practice Address - Fax:708-862-6447
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209001869363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL333920001Medicare PIN