Most Relevant Information
Provider Data
| NPI Number: | 1003361619 |
| Provider Name: | TAMYRA MICHELLE JANICKI NP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 209014617 |
Most Important Dates
| Enumeration Date: | 08/24/2016 |
| Last Updated: | 01/18/2022 |
Provider Practice Location
1315 BUTTERFIELD RD STE 206
DOWNERS GROVE
IL
605155602
Practice Location Phone/Fax
| Phone: | 6303177690 |
| Fax: | 6303177894 |
Provider Mailing Location
1315 BUTTERFIELD RD STE 206
DOWNERS GROVE
IL
605155602
Provider Mailing Phone/Fax
| Phone: | 6303177690 |
| Fax: | 6303177894 |