Provider Demographics
NPI:1205000155
Name:DUKLESKI, JANA DIMCE (MD)
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:DIMCE
Last Name:DUKLESKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JANA
Other - Middle Name:DIMCE
Other - Last Name:SAPKAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:10760 GREEN PL
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-2985
Mailing Address - Country:US
Mailing Address - Phone:219-776-9116
Mailing Address - Fax:
Practice Address - Street 1:1007 LINCOLNWAY
Practice Address - Street 2:
Practice Address - City:LA PORTE
Practice Address - State:IN
Practice Address - Zip Code:46350-3201
Practice Address - Country:US
Practice Address - Phone:219-326-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01071147A207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology