Provider Demographics
NPI:1760870356
Name:VENDL, JANESE
Entity Type:Individual
Prefix:
First Name:JANESE
Middle Name:
Last Name:VENDL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 WATERS EDGE DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60177-3705
Mailing Address - Country:US
Mailing Address - Phone:630-234-1362
Mailing Address - Fax:
Practice Address - Street 1:541 WATERS EDGE DR
Practice Address - Street 2:
Practice Address - City:SOUTH ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60177-3705
Practice Address - Country:US
Practice Address - Phone:630-234-1362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-05
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146-005590235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist