Provider Demographics
NPI:1598843526
Name:JANKOWSKA, ANNA (MA LCPC CEAP SAP)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:JANKOWSKA
Suffix:
Gender:F
Credentials:MA LCPC CEAP SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4515 N MILWAUKEE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630
Mailing Address - Country:US
Mailing Address - Phone:773-777-6767
Mailing Address - Fax:773-777-7274
Practice Address - Street 1:4515 N MILWAUKEE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630
Practice Address - Country:US
Practice Address - Phone:773-777-6767
Practice Address - Fax:773-777-7274
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL15116101YA0400X
IL180-005383101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)