Provider Demographics
NPI:1689684334
Name:MIGDOW, JANET S (MA,LCPC)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:S
Last Name:MIGDOW
Suffix:
Gender:F
Credentials:MA,LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3232 W VICTORIA ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-3624
Mailing Address - Country:US
Mailing Address - Phone:773-463-1901
Mailing Address - Fax:773-463-7955
Practice Address - Street 1:3232 W VICTORIA ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-3624
Practice Address - Country:US
Practice Address - Phone:773-463-1901
Practice Address - Fax:773-463-7955
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001608158OtherBCBS