Basic Information
| Provider Information | |||||||||
| NPI: | 1891975637 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SROKA | ||||||||
| FirstName: | JANICE | ||||||||
| MiddleName: | P | ||||||||
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| Credential: | APN | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 211699 | ||||||||
| Address2: | |||||||||
| City: | EAGAN | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551213699 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8668490692 | ||||||||
| FaxNumber: | 8889738821 | ||||||||
| Practice Location | |||||||||
| Address1: | 850 BROOK FOREST AVE | ||||||||
| Address2: | |||||||||
| City: | SHOREWOOD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604048513 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8157254918 | ||||||||
| FaxNumber: | 8157254955 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/09/2007 | ||||||||
| LastUpdateDate: | 09/09/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 209005992 | IL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.