Provider Demographics
NPI:1639251788
Name:FORD, JANET B (CNM)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:B
Last Name:FORD
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:MS
Other - First Name:JANET
Other - Middle Name:
Other - Last Name:BARROW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:810 BIESTERFIELD ROAD
Mailing Address - Street 2:SUITE 306 - WIMMER BUILDING
Mailing Address - City:ELK GROVE VILLAGE
Mailing Address - State:IL
Mailing Address - Zip Code:60007-3378
Mailing Address - Country:US
Mailing Address - Phone:847-357-1144
Mailing Address - Fax:847-357-9449
Practice Address - Street 1:810 BIESTERFIELD ROAD
Practice Address - Street 2:SUITE 306 WIMMER BUILDING
Practice Address - City:ELK GROVE VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60007-3378
Practice Address - Country:US
Practice Address - Phone:847-357-1144
Practice Address - Fax:847-357-9449
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209006117367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife