Provider Demographics
NPI:1295838779
Name:FORBES, JANET Y (MD)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:Y
Last Name:FORBES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6326 W. ROOSEVELT RD.
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60304-2313
Mailing Address - Country:US
Mailing Address - Phone:708-524-2121
Mailing Address - Fax:708-524-3199
Practice Address - Street 1:6326 W. ROOSEVELT RD.
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60304-2313
Practice Address - Country:US
Practice Address - Phone:708-524-2121
Practice Address - Fax:708-524-3199
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036064878207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
717521Medicare ID - Type Unspecified
ILD15295Medicare UPIN