Provider Demographics
NPI:1760698880
Name:DOBBELSTEIN, JANET KNOPF (MSED)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:KNOPF
Last Name:DOBBELSTEIN
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7N 336 SYCAMORE AVE.
Mailing Address - Street 2:
Mailing Address - City:MEDINAH
Mailing Address - State:IL
Mailing Address - Zip Code:60157-9647
Mailing Address - Country:US
Mailing Address - Phone:630-988-1056
Mailing Address - Fax:
Practice Address - Street 1:7N 336 SYCAMORE AVE.
Practice Address - Street 2:
Practice Address - City:MEDINAH
Practice Address - State:IL
Practice Address - Zip Code:60157-9647
Practice Address - Country:US
Practice Address - Phone:630-988-1056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILJN01050604P222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist