Provider Demographics
NPI:1700982030
Name:LANGIEWICZ, JANINA (MD)
Entity type:Individual
Prefix:
First Name:JANINA
Middle Name:
Last Name:LANGIEWICZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 EXECUTIVE CT
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SOUTH BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-9533
Mailing Address - Country:US
Mailing Address - Phone:847-304-6555
Mailing Address - Fax:847-304-6888
Practice Address - Street 1:1 EXECUTIVE CT
Practice Address - Street 2:SUITE 3
Practice Address - City:SOUTH BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-9533
Practice Address - Country:US
Practice Address - Phone:847-304-6555
Practice Address - Fax:847-304-6888
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2019-01-22
Deactivation Date:2018-10-09
Deactivation Code:
Reactivation Date:2019-01-22
Provider Licenses
StateLicense IDTaxonomies
IL336042193208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
1605500OtherBCBS
364060088OtherPPO INSURANCE
IL036079176Medicaid
MP40581OtherPRONATIONAL