Provider Demographics
NPI:1851359772
Name:SALEM, JANICE HOSKI (MD)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:HOSKI
Last Name:SALEM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1722 W SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-1037
Mailing Address - Country:US
Mailing Address - Phone:773-755-0954
Mailing Address - Fax:
Practice Address - Street 1:1525 W BELMONT AVE
Practice Address - Street 2:LAKEVIEW PEDIATRICS , SUITE 103
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-7176
Practice Address - Country:US
Practice Address - Phone:773-880-1738
Practice Address - Fax:773-472-7395
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
G24717Medicare UPIN