Provider Demographics
NPI:1336337070
Name:CETWINSKI, JANET M (OTA/L)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:M
Last Name:CETWINSKI
Suffix:
Gender:F
Credentials:OTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 MARYLAND AVE
Mailing Address - Street 2:
Mailing Address - City:OTTAWA
Mailing Address - State:IL
Mailing Address - Zip Code:61350-4537
Mailing Address - Country:US
Mailing Address - Phone:815-431-0236
Mailing Address - Fax:
Practice Address - Street 1:1300 N GREENWOOD ST
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:IL
Practice Address - Zip Code:61362-1576
Practice Address - Country:US
Practice Address - Phone:815-664-5035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant