Provider Demographics
NPI:1538556162
Name:JANTON, BEATA
Entity type:Individual
Prefix:
First Name:BEATA
Middle Name:
Last Name:JANTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BEATA
Other - Middle Name:
Other - Last Name:JANTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:4403 EDINBURG LN
Mailing Address - Street 2:
Mailing Address - City:HANOVER PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60133-2956
Mailing Address - Country:US
Mailing Address - Phone:773-564-5355
Mailing Address - Fax:773-564-5359
Practice Address - Street 1:3934 W 26TH ST STE 204
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60623-3743
Practice Address - Country:US
Practice Address - Phone:630-716-9453
Practice Address - Fax:630-489-9606
Is Sole Proprietor?:No
Enumeration Date:2015-04-21
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL277000621363LP0808X
IL209.012432363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health