Doctor Name: | MS. LORI JONES |
NPI Number: | 1083873467 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CPNP |
License Number: | 309003471 |
Business Practice Address: | 700 W Jefferson St Shorewood, IL - 604047608 |
Business Phone Number: | 8157412883 |
Business Fax Number: | 8157412860 |
Mailing Address: | 1860 Paysphere Cir, CHICAGO |
State: | IL |
Postal Code: | 606740018 |
Phone Number: | 8157412888 |
Fax Number: | |
NPI Enumeration Date: | 06/02/2008 |
NPI Last Update Date: | 10/26/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | 309003471 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |