Provider Demographics
NPI:1457419426
Name:JANOWSKI, TERESA LOUISE (DC)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:LOUISE
Last Name:JANOWSKI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 DONA CT
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:IL
Mailing Address - Zip Code:60098-2226
Mailing Address - Country:US
Mailing Address - Phone:815-858-4886
Mailing Address - Fax:
Practice Address - Street 1:770 DONA CT
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:IL
Practice Address - Zip Code:60098-2226
Practice Address - Country:US
Practice Address - Phone:158-584-8868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06912111N00000X
IL038-010428111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL7542Medicare PIN
ILIL7044Medicare PIN