Provider Demographics
NPI:1053003020
Name:BEAMISH, JANELLE MONROE (DPT)
Entity type:Individual
Prefix:
First Name:JANELLE
Middle Name:MONROE
Last Name:BEAMISH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:479 N HARLEM AVE APT 1003
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60301-6413
Mailing Address - Country:US
Mailing Address - Phone:619-219-0773
Mailing Address - Fax:
Practice Address - Street 1:887 E WILMETTE RD STE B
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60074-6495
Practice Address - Country:US
Practice Address - Phone:847-345-3384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.027477225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist