Basic Information
Provider Information
NPI: 1316976954
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TOOLE-TREXLER
FirstName: JANET
MiddleName: ELAINE
NamePrefix:  
NameSuffix:  
Credential: M.A.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 211 BURTON ST
Address2:  
City: GRAYSLAKE
State: IL
PostalCode: 600301409
CountryCode: US
TelephoneNumber: 8472239318
FaxNumber:  
Practice Location
Address1: 3001 GREEN BAY RD
Address2:  
City: NORTH CHICAGO
State: IL
PostalCode: 600643048
CountryCode: US
TelephoneNumber: 8476881900
FaxNumber: 2246102941
Other Information
ProviderEnumerationDate: 07/03/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
231H00000X ILY Speech, Language and Hearing Service ProvidersAudiologist 

No ID Information.


Home