Provider Demographics
NPI:1538374889
Name:PREPURA, JANICE A (MEDUC)
Entity type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:A
Last Name:PREPURA
Suffix:
Gender:F
Credentials:MEDUC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 W PETERSON RD
Mailing Address - Street 2:ALLIED PSYCHOLOGICAL SERVICES LTD
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048
Mailing Address - Country:US
Mailing Address - Phone:847-680-3828
Mailing Address - Fax:847-680-3844
Practice Address - Street 1:501 W PETERSON RD
Practice Address - Street 2:ALLIED PSYCHOLOGICAL SERVICES LTD
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048
Practice Address - Country:US
Practice Address - Phone:847-680-3828
Practice Address - Fax:847-680-3844
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional