Provider Demographics
NPI:1821133539
Name:AGRUSS, JANYCE (DNSC, APN, FNP)
Entity Type:Individual
Prefix:DR
First Name:JANYCE
Middle Name:
Last Name:AGRUSS
Suffix:
Gender:F
Credentials:DNSC, APN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 W NORTH AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-2135
Mailing Address - Country:US
Mailing Address - Phone:630-279-8771
Mailing Address - Fax:630-279-8576
Practice Address - Street 1:533 W NORTH AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-2135
Practice Address - Country:US
Practice Address - Phone:630-279-8771
Practice Address - Fax:630-279-8576
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner