Provider Demographics
NPI:1396826400
Name:JANECEK, MARIA J (DO)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:J
Last Name:JANECEK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6840 S. MAIN STREET
Mailing Address - Street 2:SUITE 201
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60516-3493
Mailing Address - Country:US
Mailing Address - Phone:630-852-4551
Mailing Address - Fax:630-852-0131
Practice Address - Street 1:6840 S. MAIN STREET
Practice Address - Street 2:SUITE 201
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60516-3493
Practice Address - Country:US
Practice Address - Phone:630-852-4551
Practice Address - Fax:630-852-0131
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-103654208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics