Provider Demographics
NPI:1407020365
Name:BELL, JANETTA (DEVELOPMENTAL THERAP)
Entity Type:Individual
Prefix:MISS
First Name:JANETTA
Middle Name:
Last Name:BELL
Suffix:
Gender:F
Credentials:DEVELOPMENTAL THERAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3025 MONTEREY DR
Mailing Address - Street 2:
Mailing Address - City:FLOSSMOOR
Mailing Address - State:IL
Mailing Address - Zip Code:60422-2273
Mailing Address - Country:US
Mailing Address - Phone:708-798-7290
Mailing Address - Fax:708-798-5692
Practice Address - Street 1:3025 MONTEREY DR
Practice Address - Street 2:
Practice Address - City:FLOSSMOOR
Practice Address - State:IL
Practice Address - Zip Code:60422-2273
Practice Address - Country:US
Practice Address - Phone:708-798-7290
Practice Address - Fax:708-798-5692
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILJB49271200P171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor