Basic Information
| Provider Information | |||||||||
| NPI: | 1023245511 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JANIK | ||||||||
| FirstName: | LUKE | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2043 N BISSELL ST | ||||||||
| Address2: | UNIT 2 | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606144205 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 2650 RIDGE AVE | ||||||||
| Address2: | NORTHSHORE UNIVERSITY HEALTH SYSTEM; DEPT ANESTHESIA | ||||||||
| City: | EVANSTON | ||||||||
| State: | IL | ||||||||
| PostalCode: | 602011718 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8475702000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2009 | ||||||||
| LastUpdateDate: | 09/16/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | L-239967 | MA | Y | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | MD448427 | PA | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | MT203419 | PA | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207LP3000X | 036.138618 | IL | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pediatric Anesthesiology |
No ID Information.