Provider Demographics
NPI:1437380870
Name:MONROE, JANNA (MA)
Entity Type:Individual
Prefix:
First Name:JANNA
Middle Name:
Last Name:MONROE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10501 S ALBANY AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60655-2029
Mailing Address - Country:US
Mailing Address - Phone:708-205-7667
Mailing Address - Fax:
Practice Address - Street 1:10501 S ALBANY AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60655-2029
Practice Address - Country:US
Practice Address - Phone:708-205-7667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-03
Last Update Date:2009-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist