Tamyra Michelle Janicki, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

277000587 Issued in IL

Practice address

1315 Butterfield Rd Ste 206
Downers Grove, IL 60515-5602

Phone

(630) 317-7690

Fax

(630) 317-7894

NPI assigned

Aug 24, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ageless Men'S Health Holdings, Inc

  • Physician Assistant
  • Austin, TX
  • NPI 1386923597
  NPD (past)
• Ageless Men'S Health, LLC

  • Clinical Medical Laboratory
  • Memphis, TN
  • NPI 1003098997
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1471996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1003361619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 BUTTERFIELD RD STE 206",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605155602",
            "telephone_number": "630-317-7690",
            "fax_number": "630-317-7894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 BUTTERFIELD RD STE 206",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605155602",
            "telephone_number": "630-317-7690",
            "fax_number": "630-317-7894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANICKI",
        "first_name": "TAMYRA",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-24",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209014617",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277000587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Moss DDS PLLC
• Jessica Lynn Jandak, PSY.D.
• Maria J Janecek, D.O.
• Janet Hecht Psychotherapy PLLC
• Kristina A Janich
• Jamie Sue Januszyk, M.D.
• Maura Jarka, APN
• John Lawrence Jauch, MA, LCPC
• Jeanne a Dickerson
• Olivia Jenkins, PA-C

• Family Nurse Practitioner in Downers Grove, IL
• Providers in Downers Grove, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.