Provider Demographics
NPI:1801091624
Name:JANCZAK-HARNEN, TAMMY S
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:S
Last Name:JANCZAK-HARNEN
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 1:7N960 COLUMBINE W
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60175-6643
Mailing Address - Country:US
Mailing Address - Phone:630-584-2785
Mailing Address - Fax:630-844-4565
Practice Address - Street 1:143 S LINCOLN AVE
Practice Address - Street 2:SUITE E
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60505-4263
Practice Address - Country:US
Practice Address - Phone:630-844-4284
Practice Address - Fax:630-844-4565
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist