Provider Demographics
NPI:1720015266
Name:PLONKA, JANE A (MSW)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:A
Last Name:PLONKA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1867 S LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-6485
Mailing Address - Country:US
Mailing Address - Phone:630-495-1981
Mailing Address - Fax:
Practice Address - Street 1:EDWARD HINES JR VA HOSPITAL
Practice Address - Street 2:SOCIAL WORK SERVICE 122
Practice Address - City:HINES
Practice Address - State:IL
Practice Address - Zip Code:60141
Practice Address - Country:US
Practice Address - Phone:708-202-2102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker