| Janelle Bagley Llc | |
|
1180 N Covent St Bourbonnais IL 60914 | |
| (219) 484-3233 | |
| Not Available |
| Full Name | Janelle Bagley Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1180 N Covent St, Bourbonnais, Illinois |
| Authorized Official Name and Position | Janelle Bagley (PROVIDER) |
| Authorized Official Contact | 2194843233 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Janelle Bagley Llc 460 E Bethel Dr Bourbonnais IL 60914-1134 Ph: () - | Janelle Bagley Llc 1180 N Covent St Bourbonnais IL 60914 Ph: (219) 484-3233 |
| NPI Number | 1689333239 |
|---|---|
| Provider Enumeration Date | 12/10/2021 |
| Last Update Date | 12/10/2021 |
| Certification Date | 12/08/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689333239 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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